Heart attacks in women are more likely to be fatal than in men. The reasons are differences in age and comorbidity burden that make risk assessment in women challenging. Researchers at the University of Zurich have now developed a new risk score based on artificial intelligence that improves personalized care for women with heart attacks.
Heart attacks are one of the leading causes of death worldwide, and women who experience a heart attack have a higher death rate than men. This has been an issue of concern to cardiologists for decades and has generated controversy in the medical field about the causes and effects of potential gaps in treatment. The problem starts with symptoms: Unlike men, who usually experience chest pain that radiates to the left arm, a heart attack in women often manifests as abdominal pain that radiates to the back or as nausea and vomiting. Unfortunately, these symptoms are often misinterpreted by patients and healthcare staff, with disastrous consequences.
The risk profile and the clinical picture are different in women
An international research team led by Thomas F. Lüscher, professor at the Center for Molecular Cardiology at the University of Zurich (UZH), has now investigated the role of biological sex in heart attacks in more detail.
Indeed, there are notable differences in the disease phenotype observed in women and men. Our study shows that women and men differ significantly in their risk factor profile at hospital admission.”
Thomas F. Lüscher, professor at the Center for Molecular Cardiology at the University of Zurich
When differences in age at admission and existing risk factors such as hypertension and diabetes are not taken into account, women with heart attack have a higher mortality than men. “However, when these differences are taken into account statistically, women and men have similar mortality,” adds the cardiologist.
Current risk models favor the undertreatment of women
In their study, published in the prestigious journal The Lancet, researchers from Switzerland and the United Kingdom analyzed data from 420,781 patients from across Europe who had suffered the most common type of heart attack. “The study shows that the established risk models that guide current patient management are less accurate in women and favor undertreatment of women,” says first author Florian A. Wenzl of the UZH Center for Molecular Medicine . “Using a machine learning algorithm and Europe’s largest data sets we were able to develop a new AI-based risk score that takes into account sex-related differences in baseline risk profile and improves the prediction of mortality in both sexes,” Wenzl. he says
AI-based risk profiling improves individualized care
Many researchers and biotech companies agree that artificial intelligence and Big Data analytics are the next step on the road to personalized patient care. “Our study heralds the era of artificial intelligence in the treatment of heart attacks,” says Wenzl. Modern computer algorithms can learn from large data sets to make accurate predictions about the prognosis of individual patients – the key to individualized treatments.
Thomas F. Lüscher and his team see great potential in the application of artificial intelligence to the management of heart disease in both male and female patients. “I hope that the implementation of this new score into treatment algorithms will refine current treatment strategies, reduce gender inequalities and ultimately improve the survival of heart attack patients, both men and women,” says Lüscher.
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Journal reference:
Wenzl, FA, et al. (2022) Sex-specific evaluation and redevelopment of the GRACE score in non-ST-segment elevation acute coronary syndromes in UK and Swiss populations: a multinational analysis with external cohort validation. The Lancet. doi.org/10.1016/S0140-6736(22)01483-0.