TUESDAY, July 1 (HealthDay News) -- Contradicting some earlier reports, a new study finds that women who have heart attacks benefit as much as men from the artery-opening procedure called catheterization.
But that benefit is seen only in women whose heart damage is severe enough to be classified as a heart attack, said study author Dr. Michelle O'Donoghue, a member of the TIMI Research Group at Brigham and Women's Hospital in Boston. Those who have suffered a "near heart attack" called unstable angina should be given more conservative treatment.
"There are blood tests we routinely give to see whether someone has had a heart attack, permanent damage to the heart muscle," O'Donoghue said. "When the tests are elevated, they indicate a higher risk. There is greater muscle tissue damage and so greater incentive to go to catheterization."
In that procedure, a thin wire with a balloon at its end, the catheter, is threaded to the site of a clot blocking a heart artery. The balloon is then inflated to open the artery and restore blood flow.
Some studies had found greater risk than benefit for women with suspected heart attacks. But this analysis of eight randomized trials including more than 10,000 patients, 30 percent of them women, found an overall benefit for women for whom a heart attack was diagnosed. The report was published in the July 2 issue of the Journal of the American Medical Association.
Women who had catheterization had a 19 percent lower risk of death, heart attack or rehospitalization than those who had drug treatment, the study found. For men, the risk was 27 percent lower with catheter treatment than with conservative therapy.
But the gains for women were concentrated among those whose blood tests did not show severe heart damage. For those women, the preferred strategy is "first maximize medical therapy, then catheterize only if there is ongoing chest pain or positive results on a stress test," O'Donoghue said.
It's not entirely clear why women should differ from men in this particular cardiac problem, she said. One possibility is that women are more likely to have other conditions that complicate the situation, such as diabetes, O'Donoghue said. "Or they may have a different kind of heart disease, one that affects the smaller blood vessels," she said. Catheterization would not open these small vessels.
