by Anne Hammarskjöld, Karolinska Institutet

Credit: Unsplash/CC0 Public Domain

A new study shows that women lose more years of life after a heart attack than men. A 50-year-old woman with a large heart attack loses an average of 11 years, while an 80-year-old man with a small heart attack loses an average of 5 months of life. The study was led by researchers at Karolinska Institutet and Danderyd Hospital and the results have been published in the journal Circulation.

Heart attacks are one of the most common causes of death globally and have a major impact on the life expectancy of the population. Understanding the impact of a disease on life expectancy is important for identifying high-risk groups, while also providing important insights to improve care planning in the future.

The new study examined 335,000 individuals with first-time myocardial infarction registered in the SWEDEHEART quality registry during the period 1991–2022. The individuals with myocardial infarction were compared with 1.6 million individuals without myocardial infarction using data from Statistics Sweden and the National Board of Health and Welfare.

Using the comparator population and new statistical methods, the difference in life expectancy between heart attack individuals and comparison individuals could be calculated, providing a measure of how much life expectancy was shortened due to the disease.

"We found that there were large differences between groups. Women and young individuals lost the most life expectancy when they had a heart attack. If the cardiac function was impaired after the infarction, the effects were even greater. For example, a 50-year-old woman with impaired cardiac function loses an average of 11 years in 2022 compared to an 80-year-old man with normal cardiac function who loses an average of 5 months in life expectancy," says first author Christian Reitan, researcher at the Department of Clinical Sciences, Danderyd Hospital, Karolinska Institut.

Parameters affecting heart attack risk

研究人员还能够考虑到患病时收入，教育，其他疾病和药物的差异 - 这有助于在考虑其他所有因素时衡量心脏病发作本身的影响。

“结果显示，预期寿命减少的相当大一部分消失了，也就是说，预期寿命的减少大部分是由心脏病发作本身以外的因素解释的，但可能仍然与心脏病发作有关，例如社会经济学或其他疾病，如高血压和糖尿病。如果患者保留了心脏功能，我们看到性别差异已经消失。

“我们将其解释为心脏病发作的影响，以及心脏病发作的护理，在两性之间是相似的，我们在女性中看到的预期寿命大幅缩短是由于风险因素，其他疾病和社会经济学的差异，”Reitan说。

According to the researchers, there is a lack of individualized heart attack care in Sweden for women. The study shows that women who have a heart attack lose more years of life than men of the same age.

"If a woman had impaired cardiac function, the gender difference was large. We don't have the data to answer why, but it raises questions about whether women get as good follow-up and treatment for heart failure as men, or whether it is simply a more serious condition for a woman.

"Our findings are important because they challenge existing guidelines for heart attack treatment today. By identifying high-risk groups, we can hopefully better tailor treatment to the individual. We believe that 'years of life lost' is a good and easy-to-understand measure of risk for both doctors and patients. It makes it easier for us to assess and communicate the seriousness of the disease," concludes Reitan.

More information: Christian Reitan et al, Excess Mortality and Loss of Life Expectancy After Myocardial Infarction: A Registry-Based Matched Cohort Study, Circulation (2024). DOI: 10.1161/CIRCULATIONAHA.124.068739

Journal information: Circulation 

Provided by Karolinska Institutet