Key facts
- The world's four leading cardiovascular health groups have agreed on the first universal definition of a heart attack.
- The new guidance aims to improve diagnosis and treatment, particularly for women who have historically received less effective care for certain heart attack types.
- Three types of heart attacks, often linked to childbirth, exercise, and stress, which disproportionately affect women, have been upgraded in the classification.
- The diagnostic threshold for troponin levels, a protein released when the heart is injured, will be lowered for women.
- The agreement was announced at the European Society of Cardiology congress in Munich and published in the European Heart Journal.
Doctors have established the world's first universal definition of a heart attack, a move expected to revolutionize care and address historical disparities in treatment, particularly for women.
The landmark agreement, announced at the European Society of Cardiology congress in Munich, was forged by four leading global cardiovascular health organizations: the ESC, the American College of Cardiology, the American Heart Association, and the World Heart Federation.
Historically, certain less common forms of heart attacks, which evidence suggests affect women more frequently, have been coded as less critical, leading to less effective treatments and potentially worse outcomes. These types of attacks, often caused by factors like childbirth, exercise, or emotional stress, involve reduced blood flow due to reasons other than a clot blocking the artery, such as artery tears or tightening.
The new guidelines upgrade three such types of attacks, making them more likely to be diagnosed and treated with the urgency they require. Furthermore, the threshold for diagnosing any type of heart attack in women based on troponin levels—a protein released when the heart is injured—will be lowered to align better with their specific physiological responses.
Professor Bryan Williams of the British Heart Foundation hailed the change as a "landmark moment" and a "radical shift" that could be life-changing for many women. Professor Nicholas Mills, who led the international taskforce, described it as the first truly global approach to diagnosing heart attacks and acknowledged an "unintended systematic bias against women" in previous diagnostic criteria.
The new categories aim to help patients better understand the cause of their heart attack and the subsequent treatment path. The three upgraded categories include coronary artery spasm, coronary embolism, and spontaneous coronary artery dissection (Scad), the latter occurring in women at least 80% of the time, often during or after pregnancy.