New tool can more accurately identify the risk of bleeding complications in oncology patients who have had an infarction, and has the potential to improve the personalization of their treatment.
Researchers from the Malaga Biomedical Research Institute and Nanomedicine Platform (IBIMA Plataforma BIONAND) and the Virgen de la Victoria University Hospital have discovered, through a new scientific publication, specifically in the European Heart Journal, a study that marks a significant advance in personalized medicine for patients with myocardial infarction and cancer.
Dr. Francesco Costa, cardiologist and researcher in the Institute's Cardiovascular Research for Health group, participated in this study. He leads the ORACLE project, funded by an ERC Starting Grant from the European Commission, which focuses on improving the prediction of ischemic cardiac events and bleeding in myocardial patients, using artificial intelligence for the integration of data that serve as computational biomarkers applicable to clinical practice.
In this regard, the study presents an updated version of the PRECISE-DAPT score, a key tool for assessing the risk of bleeding complications in patients receiving dual antiplatelet therapy. In addition, this research group, led by Manuel Jiménez Navarro, professor at the University of Malaga and cardiologist at the Hospital Universitario Virgen de la Victoria, is also part of the Centro de Investigación Biomédica en Red - Enfermedades Cardiovasculares (CIBERCV), attached to the Instituto de Salud Carlos III (ISCIII).
Dual antiplatelet therapy is a medical treatment used to prevent the formation of blood clots. It involves the use of two types of medications that prevent platelets, which are the blood cells responsible for clotting, from clumping together and forming clots. It is important for people who have had a heart attack, a stroke, or who have had procedures such as stenting of the arteries.
These medications help keep the arteries open and reduce the risk of future heart or circulatory problems. Although this therapy is very effective, it also increases the risk of bleeding, so physicians should carefully consider the benefits and risks for each patient.
Research has shown that incorporating cancer data into the PRECISE-DAPT score improves the tool's ability to predict bleeding risks. Dr. Costa himself has emphasized that “this work is fundamental because we can now more accurately identify cancer patients who are at high risk of bleeding,” something that in Dr. Costa's own words “not only improves treatment safety, but also facilitates more personalized and effective medical care.”
The study included more than 216,000 patients with myocardial infarction, of whom 4,569 had a diagnosis of cancer. The results showed that the new modified score, which includes cancer as a binary variable, improves predictive accuracy compared to the original score. In particular, it was observed that 94% of patients with cancer were correctly classified as being at high risk of bleeding, in contrast to 65.5% using the original score...”
In addition, Dr. Costa said that “this study not only provides a new approach to the management of patients with complex conditions such as cancer and myocardial infarction, but also underscores the importance of a comprehensive patient assessment”. The aim, he stressed, “is to improve the quality of life of patients through more precise and personalized medicine.” Finally, he assured that the findings of this study “will make it possible for professionals to efficiently adjust antiplatelet treatments, reducing risk, optimizing resources and improving the quality of life of patients with this clinical condition.
Other centers in Europe have participated in this study, such as the University of Keele, the University of Manchester and the University Hospital of Wales (United Kingdom), the University of Messina (Italy), the National Institute for Health and Care Research (Birmingham), the University of Messina (Italy) - where Dr. Costa himself began the study before starting his time at IBIMA Plataforma BIONAND -. In addition, other leading cardiology centers in other parts of the world are also participating, such as the Military Hospital of Santiago (Chile), the hospital center attached to Harbin Medical University, together with the Myocardial Ischemia Research Laboratory of the Ministry of Education (China), as well as the Transcatheter Cardiovascular Therapies Unit of the Cardiovascular Research Foundation of New York (United States).
Reference:
Dafaalla M, Costa F, Kontopantelis E, Araya M, Kinnaird T, Micari A, Jia H, Mintz GS, Mamas MA. Bleeding risk prediction after acute myocardial infarction-integrating cancer data: the updated PRECISE-DAPT cancer score. Eur Heart J. 2024 Jul 17:ehae463. doi: 10.1093/eurheartj/ehae463. Epub ahead of print. PMID: 39016180.
Raúl J. Andrade Bellido, es Investigador Responsable del grupo consolidado ‘Hepatogastroenterología, Farmacología y Terapéutica Clínica Traslacional’ de IBIMA Plataforma BIONAND, Catedrático y Director del Departamento de Medicina en la Facultad de Medicina de la Universidad de Málaga, Jefe de Servicio Aparato Digestivo del Hospital Universitario Virgen de la Victoria en Málaga. Además, es el Responsable del Grupo Español de Hepatopatias asociadas a medicamentos (Spanish DILI Registry), el Coordinador de la Red Ibero-Americana de Hepatopatías asociadas a medicamentos (SLATINDILI) y también del Registro europeo de Hepatopatías asociadas a Medicamentos (Pro-Euro DILI Registry). Chair de la COST Action CA17112 – Prospective European Drug-Induced Liver Injury Network (PRO-EURO DILI NET) y del EASL DHILI Consortium. Horizonte2020. Framework Programme (European Union).