Doctors have developed a new artificial intelligence tool to help them make better treatment decisions for patients who have both cancer and a heart attack, according to a study published in The Lancet. The authors emphasise this is one of the hardest and most challenging patients to treat.
The tool, called ONCO-ACS, was developed by an international team of researchers led by the University of Leicester. It is the first risk prediction model designed specifically for cancer patients who suffer a heart attack.
Cancer patients who have a heart attack face a particularly difficult situation. Their bodies are already under strain from cancer and its treatment, making them more vulnerable to serious complications. Depending on the type of cancer they have, they may be at higher risk of bleeding, dangerous blood clots, or both. In addition, the medications used to prevent one problem can sometimes make the other worse. Until now, doctors had no dedicated tool to help navigate these competing risks.
ONCO-ACS uses AI to combine information about a patient’s cancer with standard clinical data, producing a prediction of their chances of dying, experiencing a major bleed, or having another cardiac event within six months of the heart attack. This gives doctors reliable, personalised information to guide their choice of treatment.
The study analysed data from more than one million heart attack patients across England, Sweden and Switzerland, including over 47,000 with cancer.
“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,” said Dr Florian A. Wenzl, Honorary Fellow at the University of Leicester and first author of the paper.
“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,” added Professor David Adlam, interventional cardiologist from the University of Leicester and senior author.
The researchers hope ONCO-ACS will be integrated into everyday clinical practice, helping doctors decide on the best treatment approach for individual patients. It could also be used to design future clinical trials aimed at improving outcomes for this underserved group.
Wenzl F, Ow K, Velders M et al. Prediction of mortality, bleeding, and ischaemic events in patients with cancer and acute coronary syndrome: a model development and validation study. The Lancet, 407, 515-528