Physicians need to diagnose women with coronary heart disease at an earlier stage and provide the same interventional procedures that are commonly used for male patients, according to a statement issued by the American Heart Association (AHA) and published in the February 1st issue of Circulation.

The AHA addressed issues affecting care of women with cardiovascular disease at an event called “Go red for women,” held in New York City with a panel of experts. The scientific statement released at the meeting calls for the need to improve treatment by obtaining earlier diagnosis and referring women for currently available interventional cardiovascular therapies.

The AHA statement addresses the rising rate of mortality in women with cardiovascular disease, which is actually higher than the death rate for men with the disease. Currently, 33 million American women suffer from cardiovascular disease, claiming 489,000 lives every year, compared with 31 million men with 432,245 deaths. More specifically, 5.9 million US women will have an adverse coronary event this year, resulting in approximately 250,000 deaths. Despite these statistics, and the known benefits of interventional procedures such as angioplasty and stenting in reducing myocardial infarctions, only one third of all patients treated with interventional procedures are female.

“As proven in clinical trials time after time, interventional procedures such as percutaneous coronary interventions are safe and effective treatments for cardiovascular disease,” said Alexandra Lansky, MD, lead author of the statement, Director of the Women’s Cardiovascular Health Initiative at the Cardiovascular Research Foundation, and director of clinical services for Interventional Cardiology at New York-Presbyterian Hospital/Columbia. “In fact, the outcomes in women and men continue to improve and it is now time to translate our findings into real-world practice and start referring more women to these life-saving procedures.”

“It used to be thought that the outcomes for women undergoing percutaneous interventions were not favorable, but that is no longer true,” said Lansky. “The current data clearly show that these minimally invasive procedures are safe and effective, and in high risk patients, can reduce subsequent heart attacks and save lives.”

Female cardiovascular patients tend to have a higher risk profile compared to men when they seek medical attention. They have smaller coronary arteries, higher prevalence of diabetes, are generally older, and have more hypertension.

“It is also important to point out that women suffering from heart attacks typically delay seeking emergency medical attention. These delays lead to deaths or other lasting complications,” said Lansky. “When interpreting any clinical trial data it is always important to examine all risk factors and attributes of a certain patient population. A closer look at known clinical data reveals that it is these risk factors, and not gender per se, that is responsible for the poorer results in women.”

In the new statement, the panel identified three areas of improvement for outcomes in female cardiovascular patients. First, referral for earlier treatment upon diagnosis needs to be improved. Second, further research needs to be conducted to optimize therapy for patients with diabetes and small vessel coronary disease − two conditions extremely prevalent in the female population. Finally, the panel called for more refined treatment pathways and strategies for women who have ST-elevation myocardial infarction, a type of heart attack where mortality rates and bleeding risk remain significantly higher than in men.

“Our statement however is based on the gender-specific evidence currently available to us as healthcare professionals,” said Lansky. “To truly improve outcomes in women we need to recruit more female patients into future clinical trials, as female representation in previous percutaneous intervention trials has been 38 percent at best, and often closer to just one quarter of the studied populations.”