Irish research highlights gender gap in MI treatment

Irish research has highlighted how women are losing out in terms of treatment and outcomes following MI.

The research was presented at the recent European Society of Cardiology (ESC) 2025 congress in Madrid.

A study on sex-based disparities in STEMI outcomes looking at data on 10,229 STEMI patients from the Irish Heart Attack Audit (IHAA) from 2017 to 2023 found that compared to men, women had significantly higher crude in-hospital mortality rates (OR: 1.52, 95% CI: 1.27 to 1.83; p < 0.001). This association remained significant and was potentially amplified after adjustment (adjusted OR: 5.10, 95% CI: 1.20 to 21.67; p = 0.027).

Age, CKD and time from symptom onset to FMC were significantly associated with shock and mortality in adjusted models. Diabetes was associated with mortality but not cardiogenic shock.

The interaction term between female sex and age was significant, suggesting the relationship varies by age, with younger women having higher odds of mortality compared to younger men, though this difference diminishes with age, the authors stated.

The authors concluded that in this large, national cohort of STEMI patients, women had significantly higher odds of in-hospital mortality.

In addition, women had a  possible increased risk of presenting with cardiogenic shock after adjusting for key clinical factors including age. 

The authors said these disparities underscore the need to investigate biological, clinical and systemic factors influencing STEMI outcomes in women.

Future studies should explore sex-specific pathophysiological mechanisms and disparities in STEMI recognition and management to improve outcomes, they said.

The research, presented at the conference by Dr Ellen Beirne, was carried out by a team from the Mater, CUH, Portlaoise, St James’s Hospital, Limerick and Galway Universty Hospitals, the RCSI and the IHAA.

In another Irish presentation studying the same STEMI patient cohort from the IHAA, (presented by David Blake), it was shown that women experienced persistent delays at all key time-points from symptom onset, diagnosis to reperfusion compared to men.

For women, there were median delays of 24.5 minutes from symptom onset to FMC, 6.5 minutes from FMC to positive ECG, five minutes from positive ECG to reperfusion and 36 minutes for total symptom onset to reperfusion time.

More men sought medical help within 90 minutes of symptom onset (51.4% vs 43.9%), while more women sought help after > 12 hours (12.7% vs 9.7%).

The authors said these findings suggest ongoing gaps in patient help-seeking behaviour and potential gender bias in provider symptom recognition. 

Targeted strategies, they said, are needed to improve public awareness of early symptom recognition, particularly in females, and to address possible systemic gender bias in emergency and healthcare responses to reduce treatment delay in women with STEMI. 

Addressing these disparities may contribute to improved outcomes in female STEMI patients.