Heart Attack Screening Tools Overlook 45% of At-Risk Patients

Current cardiac screening tools may be failing to detect around 45 percent of individuals at risk of heart attacks, according to a new study conducted by researchers at Mount Sinai in the United States. The findings, published in the journal JACC: Advances, highlight significant deficiencies in existing patient care protocols, particularly in how risk scores and symptoms are utilized to prevent heart attacks.

The study reveals that relying solely on these methods may overlook many patients who could benefit from early intervention. Amir Ahmadi, Clinical Associate Professor of Medicine (Cardiology) at the Icahn School of Medicine at Mount Sinai, emphasized the importance of recognizing the presence of silent plaque buildup in arteries. “Our research shows that population-based risk tools often fail to reflect the true risk for many individual patients,” he stated.

To assess the reliability of the widely used Atherosclerotic Cardiovascular Disease (ASCVD) risk score and a newer assessment called PREVENT, the research team analyzed data from 474 patients under the age of 66 who had no prior history of coronary artery disease. Their findings indicate that if these patients had undergone evaluations just two days before experiencing their first heart attack, nearly half would have been classified as low or borderline risk. Consequently, they would not have been recommended for further testing or preventive treatments based on current guidelines.

The results showed that under the ASCVD guidelines, 45 percent of patients would not have qualified for preventive therapy or diagnostic testing. This figure increased to 61 percent when using the PREVENT calculator, which incorporates additional variables for a more comprehensive risk assessment. Alarmingly, the majority of patients—approximately 60 percent—did not exhibit symptoms like chest pain or shortness of breath until less than two days prior to their cardiac events.

Ahmadi stressed that relying on traditional risk scores and symptomatology as primary determinants for prevention is inadequate. He advocates for a shift towards atherosclerosis imaging, which can identify early signs of plaque accumulation before it leads to significant health issues. “We need to identify the silent plaque—early atherosclerosis—before it has a chance to rupture,” he noted.

The implications of this study are far-reaching, as it underscores the need for a reevaluation of how heart attack risks are assessed and managed. By improving screening methods, healthcare professionals could significantly reduce the number of undetected cases, ultimately saving lives and enhancing patient care.