Compared to Men, Women Suffering Sudden Cardiac Arrest Have Lower Rates of Coronary Artery Disease and Left Ventricular Dysfunction

November 25, 2009

Results from the Oregon Sudden Unexpected Death Study indicate that women who suffer sudden cardiac arrest are significantly less likely than men to exhibit common symptoms and have an established diagnosis of coronary artery disease.

Results from the Oregon Sudden Unexpected Death Study indicate that women who suffer sudden cardiac arrest are significantly less likely than men to exhibit common symptoms and have an established diagnosis of coronary artery disease.

A press release from Cedars-Sinai Medical Center summarized results from the study, 1,568 cases (1,012 male, 556 female) of sudden cardiac arrest identified from 2002 to 2007. Female patients in the study were older than male patients (average age of 71 years compared to 65 years in men), slightly more likely to be successfully resuscitated, had lower rates of previously documented coronary artery disease (40% of women vs. 50% of men), and had lower rates of severe left ventricular dysfunction (21% of women vs. 36% of men).

The study found “no significant differences related to gender for a variety of health issues, including obesity, blood cholesterol and triglycerides, and history of heart attack (myocardial infarction) and heart failure (left ventricular hypertrophy).” After controlling for all variables, researchers determined that “women were half as likely as men to have severe left ventricular dysfunction and a third as likely to have previously diagnosed coronary artery disease.”

The findings regarding rates of coronary artery disease in women are significant, according to the authors, because “coronary artery disease is the condition most commonly associated with sudden cardiac arrest, and symptoms of heart disease often prompt patients to see their doctors and initiate testing and therapy.” Therefore, “the lower prevalence of recognized coronary artery disease may be another barrier impeding women from discovering their risk of sudden cardiac arrest and taking preventive steps.”

This lack of symptoms that may signal a patient to consult with their physician for testing is particularly important in the case of sudden cardiac arrest because, unlike the case with myocardial infarction, patients “may have little or no warning, and the disorder usually causes nearly instantaneous death.”

Sumeet S. Chugh, MD, associate director of the Cedars-Sinai Heart Institute, said that “if

100 men have a sudden death heart attack, 40 of them will show a critical decrease in their heart’s pumping function prior to their heart attack,” yet “only 20 women of 100 will have that critically reduced pumping ability. We are able to predict sudden cardiac death in men much better than women, and for a condition that has a 95 percent chance of instantaneous death, prediction is everything.”

Men and women “have been treated identically for the prevention of sudden cardiac death,” Chugh said. “We cannot continue to do that. We need to find novel ways of predicting sudden cardiac death in women because the predictors used so far are more applicable to men.”

Journal of the American College of Cardiology.

The results of this study were published in the November 24 issue of the