News | Womens Cardiovascular Health | August 18, 2015

Women, Blacks Face Larger Loss of Life Expectancy After Heart Attack

Differences in life expectancy change may be due to disparities in care

women, blacks, larger loss of life expectancy, heart attack, JACC, study, Harlan Krumholz, Emily Bucholz

August 18, 2015 — Women and black patients lost more years of their expected life after a heart attack when compared to white men, according to a study published in the Journal of the American College of Cardiology.

Previous research has looked at sex and racial differences in survival after a heart attack, but this was the first study to account for women’s longer life expectancy in the general population and the shorter life expectancy of blacks.

“It is imperative that we understand whether disparities we observe in a specific group, like people with heart attacks, is particular to them or more broadly reflective of the experience in the population,” said Harlan Krumholz, M.D., FACC, senior study author and director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation. “We found that women and black patients are losing more years of their life after a heart attack with one of the reasons potentially being they are not receiving care on par with men and white patients. The study makes clear the disadvantage of these groups and suggests that higher quality of care for everyone might be a helpful remedy.”

Researchers used data from the Cooperative Cardiovascular Project, a prospective cohort study that includes all fee-for-service Medicare beneficiaries discharged from acute-care non-governmental U.S. hospitals with a heart attack diagnosis in the mid-1990s.

"Prior research has shown that women and men have similar mortality after a heart attack,” said Emily Bucholz, M.P.H., lead author of the study and a pediatric resident at Boston Children's Hospital. “Recognizing that women in the general population live longer than men, we asked the question of whether women who have a heart attack are actually at a survival disadvantage because they are losing more years of life after the event than men."

The study authors reviewed records from 146, 743 heart attack patients. Overall 48.1 percent of patients were women and 6.4 percent were black. Women and black patients had a higher prevalence of diabetes, hypertension and heart failure compared with white men. One of the limitations of the study was that black patients represented such a small portion of the cohort.

After 17 years of follow-up, the survival rate was 8.3 percent for white men, 6.4 percent for white women, 5.4 percent for black men and 5.8 percent for black women. However, when adjusting for differences in expected survival, women lost significantly more years of life than men. The researchers estimated that, on average, a 65-year-old white man loses 5.1 years of life after a heart attack and a white woman loses 10 years, translating to a 29 percent reduction in remaining life for men and a 41 percent reduction for women.

Black men lost 0.3 more years than white men and black women lost one more year of life than white women, equating to black patients losing 5 percent more of their expected life than white patients.

According to researchers, racial differences in life expectancy can be explained by differences in comorbidities and treatment utilization. This was not the case for women. After adjusting for differences in clinical presentation and treatment, women still lost more of their expected life than men.

“The paper again reminds us that we need to further explore the reason behind the disparity in life expectancy for female and black patients—both in our clinical practice and in our research,” said JACC Editor-in-Chief Valentin Fuster, M.D., Ph.D., MACC.

Other study limitations included 10 percent of patients were still living at 17 years of follow-up, which required extrapolation of the expected survival curves to calculate life expectancy; and quality of care for heart attack patients has improved since the mid-1990s, so the life expectancy estimates may not accurately reflect patients today.

For more information: www.acc.org

Related Content

The BardyDx Carnation Ambulatory Monitor (CAM) is a P-wave centric wearable ambulatory cardiac patch monitoring and arrhythmia detection device. 

The BardyDx Carnation Ambulatory Monitor (CAM) is a P-wave centric wearable ambulatory cardiac patch monitoring and arrhythmia detection device. 

News | Cardiac Diagnostics | July 29, 2021
July 29, 2021 — A recent clinical study from Overlake Medical Center utilizing the Bardy Diagnostics Carnation Ambula
The FDA has cleared Angel Medical Systems' second-generation AngelMed Guardian device. The implantable cardiac device detects and warns patients if they are having an acute coronary syndrome (ACS) event, including silent heart attacks. The new, second-generation device is enhanced with ease-of-use adaptations and an updated, long life battery that could potentially double the life of the implanted device

The FDA has cleared Angel Medical Systems' second-generation AngelMed Guardian device. The implantable cardiac device detects and warns patients if they are having an acute coronary syndrome (ACS) event, including silent heart attacks. The new, second-generation device is enhanced with ease-of-use adaptations and an updated, long life battery that could potentially double the life of the implanted device

News | Cardiac Diagnostics | July 01, 2021
July 1, 2021 — The U.S. Food and Drug Administration (FDA) has cleared the Angel Medical Systems Inc.
Ophthalmic optical coherence tomography (OCT) scan view of the macula in retina with vessels. Detecting heart disease with OCT imaging of the eye.Getty Images

Ophthalmic optical coherence tomography (OCT) scan view of the macula in retina with vessels. Getty Images
 

News | Cardiac Diagnostics | March 08, 2021
March 8, 2021 — In a new study from Shiley Eye Institute at UC San Diego Health, researchers have identified a potent
Alivecor's pocket ECG system allows consumers or cardiologists to record a single lead ECG. AI algorithms can determine if their ECG is normal or abnormal and identify the arrhythmia.

Alivecor's pocket ECG system allows consumers or cardiologists to record a single lead ECG strip on a smartphone. AI algorithms can determine if their ECG is normal or abnormal and identify the arrhythmia. 

News | Cardiac Diagnostics | March 03, 2021
March 3, 2021 — AliveCor recently announced a new collaboration with AstraZeneca to research new disease management s
A study of more than 100 million Americans in 3,123 counties found a correlation between cardiac death and their level of income. Getty Images Health disparities in cardiovascular disease.

A study of more than 100 million Americans in 3,123 counties found a correlation between cardiac death and their level of income. Getty Images

News | Cardiac Diagnostics | February 02, 2021
February 2, 2021 — A new study has found in the U.S.
A new study highlights the importance of continued public education regarding the risks of cigarette smoking and the failure of dual use with vaping to reduce cardiovascular risk. Getty Images

A new study highlights the importance of continued public education regarding the risks of cigarette smoking and the failure of dual use with vaping to reduce cardiovascular risk. Getty Images

News | Cardiac Diagnostics | January 06, 2021
January 6, 2021 — Smoking traditional cigarettes in addition to using e-cigarettes results in harmful health effects
The Mesuron Inc. Avalon-H90 uses magnetometers to detect myocarditis in patients without any physical contact. It uses ventricular repolarization dynamics analysis software to look for abnormalities. The vendor said it is more specific than using ECG. It detects the multidimensional dynamics of the electrical activity caused by differences in functions of electrical action potential of normal heart tissues and abnormal ones with hypoxia.

The Mesuron Inc. Avalon-H90 uses magnetometers to detect myocarditis in patients without any physical contact. It uses ventricular repolarization dynamics analysis software to look for abnormalities. The vendor said it is more specific than using ECG. It detects the multidimensional dynamics of the electrical activity caused by differences in functions of electrical action potential of normal heart tissues and abnormal ones with hypoxia. 

News | Cardiac Diagnostics | October 06, 2020
October 6, 2020 — A new technology being developed by U.S.-based Mesuron Inc.
With the advent and optimization of nuclear scintigraphy protocols using bone-avid radiotracers, cardiac amyloidosis caused by transthyretin protein (ATTR) can now be diagnosed noninvasively without a costly tissue biopsy. The radiotracer 99mTc-pyrophosphate (99mTc-PYP) binds to deposited ATTR amyloid fibrils in the myocardium and can be visualized using planar and SPECT imaging. Amyloidosis Patient Registry  #Amyloidosis

With the advent and optimization of nuclear scintigraphy protocols using bone-avid radiotracers, cardiac amyloidosis caused by transthyretin protein (ATTR) can now be diagnosed noninvasively without a tissue biopsy. The radiotracer 99mTc-pyrophosphate (99mTc-PYP) binds to deposited ATTR amyloid fibrils in the myocardium and can be visualized using planar and SPECT imaging. This is Figure 2, showing how SPECT imaging allows the reader to distinguish between blood pool activity (ventricular cavity, etc) and myocardial activity and identify regional myocardial differences in radiotracer uptake.

News | Cardiac Diagnostics | March 05, 2020
March 5, 2020 — More than 300 patients have joined the Amyloidosis Patient Registry and it is now available to the en