Cancer patients who suffer a heart attack are exposed to a particularly dangerous combination of risks: they have a higher risk of death, a higher risk of bleeding and a higher risk of other ischemic (such as heart attacks or strokes) events. Therefore, cancer patients have been systematically excluded from many clinical trials and existing risk scores. Until now, there has been no standardized risk prediction tool for this patient group.
International study with the participation of Med Uni Graz
An international research team, led by Med Uni Graz graduate Florian Wenzl, has now developed the first risk prediction model for cancer patients with heart attacks in collaboration with Maria Smolle from the Comprehensive Cancer Center at Med Uni Graz. The study, published in The Lancet, examined more than one million heart attack patients from England, Sweden and Switzerland, including over 47,000 with cancer. The results show that cancer patients have a remarkably poor prognosis: Almost one in three died within six months, around one in fourteen suffered a major bleed, and one in six suffered another ischemic event.
Research team relies on artificial intelligence
The tool, called ONCO-ACS, uses artificial intelligence to combine cancer-related and classic cardiovascular factors to predict mortality, major bleeding and ischemic events. Although cancer and cardiovascular disease are traditionally considered as separate diseases, the results emphasize the close interaction of both diseases. Depending on the characteristics of the tumor, cancer patients may have an increased risk of bleeding, an increased risk of arterial blood clots or both - each of which requires different treatment with antiplatelet drugs after the heart attack. The new tool is intended to help doctors better weigh up the benefits and risks.
"Cancer patients with heart attacks have long been neglected in clinical research, although they represent one of the most challenging groups in cardiology," says first author Florian Wenzl. "Advances in cancer treatment mean that many specialist disciplines are confronted with increasing numbers of patients with a cancer diagnosis. Multidisciplinary treatment approaches are becoming increasingly important," adds Maria Smolle.
Outlook for personalized treatment
By addressing both cancer and heart disease individually, ONCO-ACS represents a step towards holistic medicine. The researchers hope that the ONCO-ACS score will soon be integrated into clinical practice and used to plan future studies - with the aim of improving the treatment of cancer patients with heart attacks.
