Delays in treating women who suffer heart attacks could expose them to a greater rate of life-threatening complications and less favorable outcomes than their male counterparts.

Dr. Sharon O'Donnell of Dublin's Trinity College and colleagues found that women who suffer heart attacks wait longer than men to be assessed, admitted and treated. Their research is published in the Journal of Advanced Nursing.

"Our findings do not give reasons for assessment or treatment delays, but they do present factual, yet unexplained, accounts of the differences experienced by male and female patients," says Dr. O'Donnell.

Ticking Clock

The study of 613 men and 277 women uncovered the following disparities:

Men were medically assessed 20 minutes after arriving in emergency rooms, compared to 30 minutes for women, on average.

After an average wait of of 33 minutes, 95 percent of men received aspirin; 92 percent of women received aspirin after waiting an average of 55 minutes.

After 52 minutes, 43 percent of men received reperfusion therapy to restore blood flow to the heart. However, women waited an average of 70 minutes for reperfusion therapy – and only 35 percent of women received it.

Forty percent of women and 25 percent of men did not receive the therapy because it was "too late" to be clinically effective, healthcare staff stated.

Women waited three hours and 56 minutes -- 54 minutes longer than men -- to be transferred to the coronary care unit from the emergency room.

Less Favorable Outcomes?

"The image of the typical male heart attack victim must be corrected in the minds of triage nurses who carry out initial assessments ... and other healthcare staff," Dr. O'Donnell urges.

"Better healthcare training and clinical awareness are needed if women who have heart attacks are to receive the same care as men," she notes.

For example, "treatment delays experienced by women may limit their potential to achieve maximum benefit from reperfusion therapies, which have been clinically proven to work more effectively when administered early," explains Dr. O'Donnell.

"This could result in women being exposed to a greater rate of life-threatening complications and less favorable outcomes than their male counterparts," she points out.

Equitable Healthcare Practice

Approximately 120 nurses working across six coronary care units in Dublin took part in the study, completing a 25-item questionnaire for each patient admitted during a one-year period. The questionnaire was designed with input from a panel of experts and tested during two pilot studies.

Only patients who were admitted through hospital emergency rooms and who received a confirmed diagnosis of myocardial Infarction (heart attack) and were sent to the hospitals' coronary care units were included in the study. The research was funded by the Ireland's Health Research Board.

"We accept that certain myocardial Infarction presentations are more difficult to assess and that practical, everyday resources and funding issues may exacerbate treatment and decision-making delays," Dr. O'Donnell acknowledges.

"However this study does raise important concerns about equitable healthcare practice," she concludes, "and we hope that it will prompt further investigation and discussion, particularly on the issues surrounding women who suffer heart attacks."