Predicting Heart Attacks: How good are we?

Описание: Heart disease is almost ENTIRELY preventable. Period.

There are some cases that, only in hindsight can we see some obscure lab value that was off when all the "normal" labs for heart health were good.

But in almost every case it was lifestyle that put someone there. That's a hard thing to hear, but it's solidly backed up by the research. And here's the harder thing to hear--medications to fix the lifestyle are NOT going to work. Sure, they may delay the inevitable for a short period of time, but in the end, lifestyle is the only answer.

It's pretty easy to look at something like the American Heart Association's Life's Essential 8 list and see where you stand. Medicine, however, doesn't typically use this list to guess someone's risk of having a heart attack in the next 10 years. Instead, they use risk calculators to determine if someone is at risk.

But how well do these work?

Researchers from several medical centers studied how well current heart attack screening tools work. Doctors commonly use risk scores (like the ASCVD risk calculator) and look for classic symptoms such as chest pain or shortness of breath to decide who’s at risk of having their first heart attack and who should get preventive care. The goal was to find out whether these tools can accurately predict first heart attacks before they happen.

They discovered that current screening methods miss a lot of people who go on to have a heart attack (with one scale 46% missed, the other 61% missed). When they looked back at medical data, nearly half of the patients who had a first heart attack had been classified as “low risk” by the usual ASCVD score just days before the event. Even newer risk tools that include more health details (like PREVENT) failed to correctly identify many of these patients as high risk.

Most people who end up having heart attacks don’t develop classic symptoms until just a day or two before the event. Because of this, waiting for chest pain or other warning signs to appear often happens too late to help doctors prevent the attack. This means that checking symptoms alone isn’t enough to catch silent or hidden heart disease that could lead to a heart attack.

The authors argue that clinicians need better ways to spot hidden heart disease before an attack happens. Instead of relying mostly on risk scores and symptoms, they recommend finding tests that directly detect dangerous plaque in the arteries earlier. Doing this could help doctors give preventive care sooner and potentially save lives.

I've got some better ideas...

Find out more in the video.

https://www.jacc.org/doi/10.1016/j.ja...