Counting close to the heart: in Russia, they learned how to predict a heart attack in 10 years

Russian doctors have created a mathematical model that predicts the likelihood of developing heart disease for ten years ahead with an accuracy of more than 80%. The development was the result of a large-scale study: for many years, specialists have been monitoring changes in the condition of participants in order to identify "red flags" of dangerous pathologies. According to cardiologists, the main advantage of the development is the ability to prevent the disease even before it occurs. However, the system needs to be tested on more patients before implementation.

A model for predicting a heart attack

Scientists from Yaroslav the Wise Novgorod State University and South Ural State Medical University have created a mathematical model that predicts the risks of cardiovascular diseases and diabetes for a decade ahead with an accuracy of more than 80%. The calculations take into account five key indicators: the level of so-called bad cholesterol, age, gender, leptin levels and fibrinogen levels. A large-scale study has shown that the development of pathologies varies markedly depending on gender. If the subject is a man, a special coefficient is added to the formula, which further increases the likelihood of developing the disease.

— Traditional risk assessment scales, such as SCORE2, are focused only on a short-term forecast and do not take into account the assessment of lifetime risk. Now it is important to develop models that predict the state of human health based on a variety of factors from different fields. It's not just about genetics, cardiovascular diseases, or metabolic disorders, but also about sex differences. According to modern data, adipose tissue is distributed differently in men and women. The mechanisms of blood pressure regulation also have sex differences. Therefore, it was important to create a model that would take into account the most significant factors that change the functioning of the heart, blood vessels and kidneys," said Vasily Chulkov, director of the Institute of Medical Education at NovSU.

It's better to treat: strokes and heart attacks are not only found in the elderly

Doctors told how overweight, smoking, physical inactivity and poor sleep trigger vascular disasters.

The main signs of disease development for men and women were identified based on the results of a large-scale 10-year study of patients aged 18 to 44 years. This is the most important "window of opportunity" when it is possible to prevent the development of serious diseases in the future. The presence of risk factors during this period triggers many subtle changes in the internal organs, which eventually determine the trajectory of aging.

From 2013 to 2016, doctors analyzed the condition of 251 patients at clinics in Chelyabinsk. A repeat examination of the same group took place 10 years later, in the period from 2023 to 2026. The proportion of men was 48%, women — 52%.

All patients underwent comprehensive clinical and laboratory diagnostics. During the work, the scientists adjusted the mathematical model and assessed how accurately it predicts the condition of patients a decade later based on the initial data.

The results proved that men and women have a different metabolic syndrome (a complex of disorders leading to obesity and diabetes).

"The systemic inflammatory response in men is confirmed by high levels of uric acid and tumor necrosis factor alpha," Vasily Chulkov emphasized. — In women, the leading links of pathology are a high level of leptin and a decrease in adiponectin, which together disrupt carbohydrate metabolism.

Statistical processing made it possible to identify the markers to which a person is most sensitive, depending on gender. For women, the leptin level was above 29.1 nanograms per milliliter, and for men, the "bad cholesterol" index was above 3.76 millimoles per liter. Knowing these thresholds allows you to quickly assess the patient's cardiometabolic risk level without complicated calculations.

An increase in the level of "bad" cholesterol or fibrinogen by one unit increases the likelihood of developing metabolic syndrome by about two times. Each additional year of life increases this risk by 8.9%, and leptin concentration is associated with a 7.1% increase in odds per unit of measurement.

The developed model determined true positive results in 76.7% of cases, and true negative results in 83.5%. The overall accuracy of the forecast was 80.1%.

Implementation in practice

According to Marina Chumakova, a leading market expert at NTI Helsnet, the developers of the model have achieved high forecast accuracy, but much more extensive tests are needed for its practical application.

— This is a significant step towards personalized diagnosis. However, at this stage it is more correct to call the model itself a promising pilot project. 250 participants is not much, although it is already a significant result. The accuracy is stated to be quite high, and testing the model on patients from other regions and with a wider age range will show whether such accuracy will be maintained on a diverse group of people," she said.

The new prognostic model will be useful, since now the attention of doctors is increasingly shifting towards preventive medicine, said Daria Chentsova, cardiologist at the RUDN Clinical Diagnostic Center.

— As a practicing cardiologist, I can say that if the model becomes widely used, it will undoubtedly interest colleagues. Numerical calculations will become a convincing argument for patients, encouraging them to change their lifestyle and start treatment on time. The study covers the most able-bodied part of the population, so monitoring this particular group is critically important. Having discovered deviations, the doctor can develop a non-drug correction plan even before prescribing medications. The model reconfirmed that lifestyle modification plays a key role and that the patient himself is able to significantly influence his prognosis. By reducing the risk of cardiovascular disasters, doctors simultaneously reduce the financial burden on healthcare, reducing the number of visits to doctors, prescriptions, and hospitalizations. But the main thing, the cardiologist emphasized, is that this development will become a visual reference point for the patients themselves.

— As a practicing cardiologist, I can say that if the model becomes widely used, it will undoubtedly interest colleagues. Numerical calculations will become a convincing argument for patients, encouraging them to change their lifestyle and start treatment on time. The study covers the most able—bodied part of the population, so monitoring this particular group is critically important," she said.

Having discovered deviations, the doctor can develop a non-drug correction plan even before prescribing medications. According to her, the model confirmed that lifestyle changes play a key role and that the patient himself is able to significantly influence his prognosis. By reducing the risk of cardiovascular disasters, doctors simultaneously reduce the financial burden on healthcare: the number of visits to doctors, prescriptions, and hospitalizations are reduced. But the main thing, the cardiologist emphasized, is that this development will become a visual reference point for the patients themselves.

The work was supported by a grant from the President of the Russian Federation "Predictors of the development of cardiometabolic diseases in young people."