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Generally, men and women are subject to equal clinical and pharmacological treatment[3]. However, studies show that MI continues to be more lethal in women regardless of age and their co-morbidities.  In addition, data from clinical trials about management of women with acute coronary syndrome (ACS) are limited as women are under-represented in randomized control trials .

Factors that contribute to increased morbidity and mortality in women include increased co-morbidities such as diabetes, hypertension and hyperlipidemia due to their increased age at the time of presentation. As well, women present with more complications such as re-infarction, strokes, pulmonary edema, shock and cardiac rupture.

  • Younger women have a higher mortality rate than men of comparable age, since overall event rates are low and women are often under-diagnosed compared to men.

  • Women are less likely to receive aspirin, beta blockers and statins compared to male.  In a European heart study of 3,800 patients, 73% of women were treated with ASA vs. 81% of men and 45% of women received statins vs. 51% of men .

  • In a study in USA, women were found to have to wait longer than men for examination and ECG in the emergency department.

  • Studies show that women whose symptoms are similar to men, are less likely to be admitted to a Coronary Care Unit, especially at an older age. Considering that a Coronary Care Unit is one of the potential places for aggressive management and evidence-based therapies, under representation of women to these environments may be a reason for lack of therapeutic success[2].


2. Jacobs, A.K., Brooks, S.F., Mori, M., Faxon, D.P., Chaitman, B.R., Bittner, V., Mock, M.B., Weiner, B.H., Winston, D.L. et al. (1998) Better Outcome For Women Compared With Men Undergoing Coronary Revascularization A Report From the Bypass Angioplasty Revascularization Investigation (BARI). Circulation, 98: 1279-1285.

3. Blackwell, M., Huckell, V., Turek, M., (2000) The Medical Managment of Acute Coronary Syndromes and Chronic Ischemic Heart Disease in Women. Canadian Cardiovascular Society Consensus Conference, October 2000, 7/1-7/15.

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