Compared with men, women die more frequently of a heart attack. Reasons are differences in age and concomitant diseases, which also complicate risk assessment in women. Using artificial intelligence, researchers at the University of Zurich have developed a new risk assessment that improves personalized care for women with heart attacks.
Heart attack is one of the leading causes of death worldwide. Women who suffer a heart attack have a higher mortality rate than men. This finding has concerned cardiologists for decades and has led to medical controversies about the causes and effects of any treatment gaps. The problem starts with symptoms: Unlike men, who usually experience painful pressure on the chest with radiation to the left arm, a heart attack in women often results in abdominal pain and radiation to the back or nausea and vomiting. However, these symptoms are often misinterpreted by those affected and the doctors providing initial care - with disastrous consequences.
Risk profile and disease pattern is 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 examined the role of biological sex in heart attacks in more detail. ’Our study shows that women and men differ significantly in their risk factor profile at hospital admission. The clinical picture of women and men with heart attacks is also different,’ says Lüscher. ’For example, female patients have a higher mortality than male patients when age differences at admission and existing risk factors such as hypertension and diabetes are disregarded. ’However, when these differences are taken into account statistically, women and men have similar mortality,’ the cadiologist adds.
Current risk models favor under-treatment of patients
In their study, published in the prestigious journal ’The Lancet’, researchers from Switzerland and the United Kingdom analyzed data from 420,781 female and male patients from across Europe with the most common type of heart attack. ’Among other things, the study shows that established risk models that guide current patient management are less accurate in women and favor the undertreatment of female patients,’ said first author Florian A. Wenzl of the Center for Molecular Medicine at UZH. ’Using machine learning and the largest datasets in Europe, we have developed a novel risk score that accounts for gender differences in risk profile and improves prediction of mortality in women and men,’ Wenzl said.
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 attack patients,’ Wenzl says. ’Modern computer algorithms can learn from large data sets and make accurate predictions about the prognosis of individual patients. And these, in turn, are the key to individualized treatments.
Thomas F. Lüscher and his team see great potential in the application of artificial intelligence to improve the treatment of heart disease in both male and female patients. ’We hope that the use of the new risk assessment will refine current treatment strategies, reduce gender inequalities and ultimately improve survival, especially for women with heart attacks,’ Lüscher says.
Literature:
Florian A. Wenzl et al. Sex-specific evaluation and redevelopment of the GRACE score in non-ST-segment elevation acute coronary syndromes in populations from the UK and Switzerland: a multinational analysis with external cohort validation. The Lancet. 29 Aug 2022. DOI: 10.1016/S0140-6736(22)01483-0.
