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Heart Attack Predictions Need Update: Study

Existing calculations on risk leave out important facts, researchers say

MONDAY, Oct. 7, 2002 (HealthDayNews) -- Current methods used to predict whether a heart attack patient will die or have another heart attack need to be updated, says a study in tomorrow's online issue of Circulation.

Existing calculation methods derived from clinical trials leave out important facts, such as whether a person has other diseases, that could help doctors better predict a person's risk and decide on the best treatment.

"In our study, we found that scores used to predict risk in heart attack patients should consider a patient's other health problems (comorbidity) and a measure of the heart's pumping strength (ejection fraction)," says study senior author Dr. Veronique L. Roger, of the Mayo Clinic Foundation in Rochester, Minn.

"We believe that the current scoring systems should be re-evaluated because most scores do not consider either variable," Roger says.

She and her colleagues reviewed heart attack records for 1,279 people in Olmsted County, Minn., between 1983 and 1994. The heart attacks were classified as either ST segment elevation (STEMI) or non-ST segment elevation (NSTEMI), according to their electrocardiographic presentation.

They selected two current scoring systems to determine their accuracy in predicting death or a recurrent heart attack in the study group. One scoring method comes from a clinical trial known as TIMI and the other from a community-based study called PREDICT.

Using an average follow-up marker of six years, the researchers found similar survival rates for the STEMI and NSTEMI patients. The accuracy of the TIMI score was good for STEMI patients and fair for NSTEMI patients.

The PREDICT score was consistently better than the TIMI. The researchers believe that's because the PREDICT system takes into account the effects of other diseases such as diabetes and high blood pressure.

More information

You can estimate your heart attack risk at the U.S. National Heart, Lung, and Blood Institute.

SOURCE: American Heart Association, news release, Oct. 7, 2002
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