New AI tool helps doctors treat cancer patients after heart attack

Cancer patients who suffer a heart attack face increased risks because of their weakened cardiovascular system. This means they are more likely to die, bleed or experience another serious cardiovascular event.

Depending on the tumour characteristics, cancer patients can be at elevated risk of bleeding, of arterial blood clotting, or both – each requiring different anti-platelet medication for secondary prevention after the acute event.

Until now, doctors had no standard tool to guide treatment in this vulnerable group, but now an international team of researchers, led by the University of Leicester, has developed the first risk prediction model designed specifically for cancer patients who have a heart attack.

Called ONCO-ACS, the tool uses artificial intelligence to combine cancer-related factors with standard clinical data to predict the chances of death, major bleeding, or another cardiac event within six months. 

The study, which has just been published in The Lancet, analysed more than one million heart attack patients from England, Sweden and Switzerland, including over 47,000 with cancer.

Dr Florian A. Wenzl, a University of Leicester Honorary fellow and first author on the paper, said: “Cancer patients with heart attacks have long been neglected in clinical research, despite being one of the most challenging groups we see in cardiology. 

“Results in this study showed that cancer patients had strikingly poor prognosis: nearly one in three died within six months, while around one in 14 suffered a major bleed and one in six experienced another heart attack, stroke, or cardiovascular death.

“Now this new tool is able to give doctors reliable information to tailor treatment and balance the benefits and harms.”

Professor David Adlam, interventional cardiologist from the University of Leicester’s Department of Cardiovascular Sciences and senior author added: “Significant advances in the management of heart disease and cancer alike have created new opportunities for these conditions to coexist. As a result, the growing overlap between cancer and heart attacks will confront cardiologists and oncologists with an increasingly complex patient population. We are addressing this pressing issue through a real-world data perspective.”

The researchers hope the ONCO-ACS score will soon be integrated into clinical practice to support decisions on catheter-based treatment and antiplatelet therapy. 

ONCO-ACS provides a validated approach to implement clinical practice guidelines. The new tool can also help to design future trials aiming to improve outcomes in cancer patients who suffer a heart attack.

Senior author Professor Thomas F. Lüscher from the National Heart and Lung Institute, Imperial College London and the Royal Brompton and Harefield Hospitals said: “By accounting for both cancer and heart disease, ONCO-ACS marks a step towards truly personalised medicine.”

The study was funded by Cancer Research UK and the British Heart Foundation and supported by Health Data Research UK’s Big Data for Complex Diseases Driver Programme.