Finding the bigger picture behind heart attacks

The number of people surviving heart attacks has improved enormously in recent decades – but little is known about what happens to patients afterwards. Helping healthcare professionals, patients and researchers understand what other diseases heart attack survivors may have, or might go on to develop, could lead to new treatments and better health outcomes.

Dr Marlous Hall, a senior epidemiologist at LIDA, is leading a Wellcome Trust-funded project to investigate using electronic health record data gathered by NHS Digital – accessing around 145 million records of hospitalisations in England.

Through previous work funded by the British Heart Foundation (BHF), the team identified that nearly 60 per cent of patients hospitalised with a heart attack will also have at least one other chronic condition, likely to reduce their life expectancy by around three years. Conditions such as heart failure, hypertension and peripheral vascular disease, a circulation disorder that affects blood vessels outside the heart.

“We want to find out why people might be susceptible to these other types of disease – is it just because they are living longer, or are there other reasons connected to their heart condition, that we need to be considering?” explains Dr Hall.

Identifying these patterns and links could help inform patients, doctors and the wider research community about what combinations of diseases might occur together and which treatment combinations may need to be developed in future.

“Current treatment guidelines will typically look at the individual diseases,” says Dr Hall. “But if we can understand how, for example, a heart attack might progress towards heart failure, we should be able to devise better long-term treatment plans that could manage these diseases in combination – reducing the treatment burden on patients – or prevent their onset altogether.”

The work has already been used by the British Heart Foundation in a campaign to improve awareness of heart failure and associated illnesses.

“As the population gets older, more and more people who experience a heart attack are already suffering from a number of other illnesses,” says British Heart Foundation Associate Medical Director, Jeremy Pearson.

“We need to make sure that we’re providing the best possible care for people with these conditions, to both reduce their chance of having a heart attack and to give them the best possible chance of recovering from a heart attack should the worst happen.”

In future, the team plans to broaden out the approach, looking at different diseases to understand the risks patients with one disease have of developing other health conditions.

LIDA’s IT infrastructure is fundamental to the success of research programmes like these since the ability to store sensitive information securely is key to the partnership with NHS Digital.

Dr Hall says: “There are great resources available, including hospital and GP records, but it’s not easy to access or process such vast quantities of data and use it to provide meaningful insights whilst also sticking to extremely rigorous ethical standards. Through the collaborative environment in LIDA, we’re able to do that, so all that data becomes extremely powerful for both researchers and for the overall benefit of patients.”