Surgical procedures to restore blood flow to the heart are no riskier for women than for men, according to a new study that contradicts previous research.
Men and women who undergo bypass surgery or angioplasty, in which a tiny balloon is used to clear clogged arteries, had similar rates of in-hospital deaths and five-year survival."The message is if women are in need of one of these procedures, we can recommend them with enthusiasm and anticipation of a good acute and long-term result," said Dr. Alice K. Jacobs of Boston Medical Center.
Her study was published in Circulation, a journal of the American Heart Association.
Many earlier studies concluded that women undergoing heart bypass surgery were more than twice as likely to die. The death rates were higher for women after angioplasty, as well. However, the women in some of these studies tended to be older and sicker than the men.
In this study, the men and women were far closer in health and in age. However, Jacobs said the similar results for men and women this time may have been due instead to advances in technique and technology.
For example, she said, doctors now can use smaller catheters in angioplasty that may be better for women's smaller blood vessels.
Doctors are also getting better at taking into account the fact that women are older and sicker by the time they have surgery, and they are adapting their techniques accordingly, Jacobs said.
Heart disease is the leading killer of U.S. women, but it typically strikes women 10 years later than men, when they are more likely to be weaker and have other ailments associated with aging, such as high blood pressure, high cholesterol and diabetes.
Jacobs' study involved 1,829 patients undergoing either bypass surgery or angioplasty. Twenty-seven percent of the participants were women. The women as a group were older by three years, and almost half were over 65.
Of the women who had bypass surgery, 1.3 percent died in the hospital, compared with 1.4 percent of the men. After angioplasty, less than 1 percent of the women vs. 1.2 percent of the men died.
The death rates five years after the procedures also were similar. Eighty-seven percent of the women were still alive, as were 88 percent of the men. Seventy-five percent of the women survived five years without another heart attack, as did 77 percent of the men.
Dr. Timothy Gardner, chairman of the surgical council for the American Heart Association, said the study is good news for women with heart disease.
"I think the importance of this study is that women who are diagnosed ought not to think they're in a worse situation than males," Gardner said.