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NEW YORK (Reuters Health) - Women may be more likely to die after a heart attack than men, but they are less likely to die after developing unstable angina, a type of worsening chest pain caused by heart disease, Canadian researchers report.

These findings are in agreement with a number of reports published in recent years. "However, to our knowledge, no prior population-based studies have examined both (angina and heart attack patients) simultaneously to explain" the gender differences in death risk, senior author Dr. Paul W. Armstrong, from the University of Alberta in Edmonton, and colleagues note.

The results, which are reported in the Archives of Internal Medicine, are based on a study of 22,967 heart attack patients and 8441 angina patients who were discharged from Alberta hospitals between 1993 and 2000.

Compared with men, women were older, had more diseases, were more often diagnosed with unstable angina, and were 30 percent less likely to have had an operation to open blocked blood vessels of the heart.

Women were 19 percent less likely than men to die within 5 years of unstable angina onset, the authors report. Although no overall gender effect was seen on the death risk after heart attack, among people younger than 65 years, women were much more likely to die than men.

"The reasons why (heart attack) poses a greater threat than unstable angina to women are not entirely clear, although they likely relate to a host of interrelated biological, process-of-care, lifestyle, and socioeconomic factors," the investigators note.

Clearly, further studies are needed to better understand the mechanisms involved and the policy implications.

SOURCE: Archives of Internal Medicine, November 10, 2003.

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