What factors are most predictive of a heart attack?

Posted on by kaitiscotland

Dr Malcolm Kendrick recently discussed a paper in which computers analysed routine clinical data from UK GP practices to identify the factors that most accurately predicted a cardiovascular event over the next ten years.  All the 378,256  people whose records were analysed were initially free of cardiovascular disease and 48 variables were identified.

The top ten things that were most likely to see you in hospital with a heart attack or stroke, in order,  were:

Chronic Obstructive Pulmonary Disease

Prescribed oral steroids

Older age

Severe mental illness

South Asian ethnicity

Prescribed immunosuppressants

Socio-economic deprivation

Chronic Kidney Disease

 

The least predictive were LDL, Forced expiratory volume ( a measure of asthma) and AST/ALT ( a measure of liver function).  Total cholesterol was 25th.

Can machine learning improve cardiovascular risk prediction using routine clinical data? http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0174944

Published by kaitiscotland

I am a Scottish doctor who is working to improve the outcomes for people who have diabetes using a low carb diet, and advanced insulin techniques when necessary. Professionally I provide expert witness reports in the clinical forensic and family medicine areas and I also provide complementary therapies. I enjoy cooking, cinema, reading, travel and cats.

4 thoughts on “What factors are most predictive of a heart attack?”

  1. Interesting list.

    Chronic Obstructive Pulmonary Disease ✘
    Prescribed oral steroids ✘
    Older age ✔︎
    Severe mental illness ✘
    South Asian ethnicity ✔︎
    Prescribed immunosuppressants ✘
    Socio-economic deprivation ✘
    Chronic Kidney Disease ✘

    Liked by 1 person

  2. Yes, Gary. The list I have is 7 of the ten but there were several groups listed under socio economic deprivation and I lumped them together. My mother who died aged 46 of a heart attack had 1 of these severely and two to some extent. Doctors don’t think of these in this way and the usual individual things such as smoking, obesity, and high cholesterol get attention but the big elephants in the room are ignored.

    Like

  3. In the US an issue has been raised about the use of imosuppressants to halt the immune attack on Beta Cells. One issue we often discuss is what happens at the outset of a destructive attack. It is a popular topic among parents, who see the immosupressant Remicaide, or Enbral as preventative if an attack can be caught early. THsi might tell is to not do that so quickly.

    I wonder if injectable corticosteroids (we commonly prescribe these for RA) are included in this list?

    Liked by 1 person

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