A new study by researchers at UMDNJ-Robert Wood Johnson Medical School has found that women between the ages of 35 and 54 were more likely to die in hospitals following heart attacks than men of a similar age. This finding from a sample of more than 423,000 patients can be seen as surprising, given that women, on average, develop their first acute myocardial infarction -- or heart attack -- about 10 years later than men, and are overall less likely to develop myocardial infarction than are men. The study was published in the July 2010 issue of the American Journal of Cardiology.

Led by John B. Kostis, MD, the John G. Detwiler Chair of Cardiology, chair of the department of medicine, and founding director of The Cardiovascular Institute of New Jersey at UMDNJ-Robert Wood Johnson Medical School and chief of medical service at Robert Wood Johnson University Hospital, the research team examined a statewide New Jersey database known as Myocardial Infarction Data Acquisition System (MIDAS) that tracks myocardial infarction hospitalizations and coronary heart disease deaths from 1990 to 2004. The team looked at data in four age groups: 35 to 54, 55 to 64, 65 to 74 and greater than age 75.

"During the 15-year period of study, fewer young women (ages 35 to 54) were hospitalized with myocardial infarction than men, however a greater percentage of them died," said Dr. Kostis.

According to Dr. Kostis, the marked difference of in-hospital deaths of young women compared with young men could be attributed most directly to the fact that a greater percentage of young men died out-of-the-hospital from coronary heart disease.

However the study also indicated that gender-related differences in treatment appeared to play a role in in-hospital deaths of young women versus young men, and that these differences narrowed with each increasing age group. Young women were less likely to undergo invasive cardiovascular procedures, including cardiac catheterization, percutaneous coronary intervention, and coronary artery bypass grafting than young men.

The study also found that mortality rates in the past 15 years have decreased significantly for both young women hospitalized for myocardial infarction and for young men who die from coronary heart disease outside of the hospital.

"Improved education of the risks of heart disease and of its different presentation in men and women has helped us better treat patients and ultimately reduce the mortality rate of young women and men," Dr. Kostis said.