Recurrent coronary heart disease (CHD) events, including repeat myocardial infarctions, have dropped in the United States, according to a new study published in Circulation. Almost completely across the board, outcomes have improved more for women than for men.
The authors explored data from both Medicare and commercial health insurance providers, tracking more than 770,000 women and more than 700,000 men who were hospitalized for a MI from 2008 to 2017.
Overall, among women, recurrent MIs dropped from 89.2 per 1,000 person-years in 2008 to 72.3 per 1,000 person-years in 2017. For men, recurrent MIs dropped from 94.2 in 2008 to 81.3 in 2017.
In two key demographics, however—women from 21 to 54 years old and men from 55 to 79 years old—the rate of recurrent MIs did not decline at all.
Recurrent CHD, hospitalization due to heart failure and all-cause mortality also declined among hospitalized MI patients. Recurrent CHD among women, for instance, dropped from 166.3 per 1,000 person-years in 2008 to 133.3 per 1,000 person-years in 2017. For men, recurrent heart disease dropped from 198.1 in 2008 to 176.8 in 2017. Once again, significant improvements for all patients—but a noticeably bigger improvement for women.
“We expected to see a decline in the rate of events, however, we did not expect the rates to differ between the sexes,” lead author Sanne A. E. Peters, PhD, a senior lecturer at the George Institute for Global Health in London, said in a statement. “It may be that the improvements in men were achieved before our study period, leaving less room for improvement in the most recent decade. It could also be that the attention paid to heart disease in women over recent years has resulted in the greater gains. However, regardless of the improvements, the rates of recurrent events in people who survived a heart attack are still very high in both sexes.”
The analysis did not include info on the severity of each MI, the authors noted, so it is possible this reduction in recurrent events is related to a reduction in severity over the years.