Routine Cardiac Catheterization May Benefit Some Women With Heart Disease
New research from Brigham and Women’s Hospital (BWH) finds that women who are diagnosed with a heart attack stand to benefit as much as men from routine cardiac catheterization. This is contrary to prior reports that women might not benefit from the procedure. However, for women diagnosed with a “near” heart attack, also known as unstable angina, the risks of routine cardiac catheterization may well outweigh the benefits.
Cardiac catheterization is an invasive procedure that allows doctors to find and open potential blockages in the coronary arteries in order to help prevent heart attacks and even death. The procedure is commonly performed on patients in the hospital with unstable heart disease. However, results from some earlier trials did not show any benefit with routine cardiac catheterization in women. In the current study, the researchers combined data from across eight clinical trials, comparing invasive versus conservative treatment strategies in more than 10,000 men and women patients with unstable heart disease.
"There’s a tremendous need to better understand gender differences in cardiac care. Heart disease continues to be the number one killer in women and yet women remain underrepresented in clinical trials”, said Michelle O’Donoghue MD, a researcher with the TIMI Study Group at BWH and a Physician in the Cardiology Division at Massachusetts General Hospital. “Our results now confirm that men and women who have had a heart attack appear to have a similar benefit from an early invasive strategy that involves cardiac catheterization.”
She continued, “However a more conservative approach should be used in lower risk women who have not had a heart attack. In these cases we would recommend a more conservative approach that involves maximal medical therapy and performing a catheterization only for those women with ongoing symptoms or a positive stress test.”
These new findings support the recently updated guidelines from the American College of Cardiology and the American Heart Association that now recommend a more conservative treatment strategy in lower-risk women with heart attacks and unstable angina.