A new international study has shown that artificial intelligence (AI) can transform how doctors assess risk and guide treatment for patients with the most common type of heart attack.
The research, published in The Lancet Digital Health, suggests that some patients may need to be reclassified into new risk categories, with significant implications for clinical assessment and treatment of heart attacks worldwide.
Doctors caring for patients with non-ST-elevation acute coronary syndrome (NSTE-ACS), the most common form of heart attack, rely on the GRACE score to estimate risk and guide treatment decisions, including the timing of catheter-based interventions and stent placement. The GRACE score is already widely used and increasingly integrated into international clinical guidelines. However, existing tools have long been recognised as unable to fully capture the complexity of these patients.
In the largest study on risk modelling in NSTE-ACS to date, researchers analysed health data from more than 600,000 patients across 10 countries. They also used AI to re-analyse clinical trial data from the landmark VERDICT trial, teaching the model to recognise which patients benefit most from early invasive treatment, including angiography and stenting.
GRACE 3.0 is the most advanced and practical tool yet for treating patients with the most common type of heart attacks. It not only predicts risk more accurately but also guides personalised treatment. This could reshape future clinical guidelines and help to save lives."
Thomas F. Lüscher, Adjunct Professor from the School of Cardiovascular and Metabolic Medicine and Sciences, King's College London, and Consultant Cardiologist, Royal Brompton and Harefield Hospitals
The results show that while some patients benefit greatly from early treatment, others see little or no improvement. This suggests that current approaches are not fully tailored to individual patients and, in some cases, may focus on those least likely to benefit. Reassessing how patients are grouped and treated could therefore lead to better outcomes.
Our study shows how artificial intelligence can change the way we treat heart attacks. By re-analysing clinical trial data, our model learnt who benefits from early invasive treatment and who does not. This may imply a major shift in how we should be managing these patients."
Dr Florian A. Wenzl, first author from NHS England and the Center for Molecular Cardiology, University of Zurich
The international team of researchers hopes that the new GRACE 3.0 score will support doctors in routine clinical practice by providing a simple, validated, and AI-powered tool to deliver more personalised and effective care for patients with heart attacks.
