Heart attack risk is underestimated

The risk of heart attack patients having repeat attacks after they are discharged is being underestimated, a study shows.

Doctor using a stethoscope on a patient

The research, led by the University, looked at data that included more than 46,000 heart attack patients from 115 hospitals in 14 countries.

The international study raises concerns that some patients may not be receiving the best medical treatment because doctors are misjudging the risk of a further heart attack.

Difference of severity between attacks

Researchers looked at whether patients were originally admitted with a “full” heart attack - where the artery was completely blocked - or an “incomplete” heart attack - where there was only partial blockage of the artery.

“Full” heart attack patients had the most likelihood of another heart attack or death within the first 15 days after they were first admitted.

However, the risk for patients whose heart attack was originally considered not as severe (where the artery was not completely blocked) overtook the full heart attack group after 26 days.

The findings contradict the assumption that “full” heart attack patients are the most at risk after hospital discharge.

Risk assessment

The study calls on doctors to use the GRACE (Global Registry of Coronary Events) risk assessment.

The assessment takes in factors including age, heart rate, blood pressure, kidney function, heart failure and the type of heart attack.

However, although the assessment is recommended by the European Society of Cardiology, American College of Cardiology and American Heart Association it is not routinely used.

Presentation of findings

The study is published in the journal Nature Clinical Practice and data was taken from the Global Registry of Coronary Events.

Professor Keith Fox, British Heart Foundation Professor of Cardiology at the University, will present the findings at the European Society of Cardiology in Munich next week.

Two-thirds of adverse events after a heart attack – which may be a further heart attack, stroke or major bleed – happen after a patient has been discharged from hospital. Our findings are of concern because we believe that the risk for patients whose heart attack was originally considered not as severe may be being misjudged.

Professor Keith FoxProfessor of Cardiology