Heart attacks more likely to be fatal among people with no risk factors, new research finds



Jennifer Tucker goes to the gym five times a week and loves eating healthy food.

The fit mother of two had absolutely no risk factors for heart disease such as high blood pressure or cholesterol, smoking or a family history, but at the age of 35, she knew something was wrong.

“I couldn’t push a pram uphill without becoming breathless, so I knew something wasn’t right, that I wasn’t 100 per cent,” Ms Tucker said.

The first GP she saw dismissed her concerns, but the second doctor sent her for a range of tests.

A heart angiogram revealed why she had been feeling so unwell.

“I was absolutely stunned when they told me my heart was 90 per cent blocked,” Ms Tucker said.

Risk of death increases by 50 per cent

Cardiologist Professor Gemma Figtree shows Jennifer Tucker an image of the blockage in one of her arteries on a large screen.
Cardiologist Gemma Figtree shows Jennifer Tucker an image of the blockage in one of her arteries.(ABC News: Brendan Esposito)

New research from Sydney’s Royal North Shore Hospital and the Australian Cardiovascular Alliance, which has been published in The Lancet medical journal, has revealed when people like Ms Tucker have heart attacks, they actually fare worse than people who have pre-existing health problems like high blood pressure.

Cardiologist Gemma Figtree analysed more than 62,000 people who had heart attacks from plaque in their coronary arteries, from data collected from a Swedish heart registry.

“Despite their perceived low risk of having coronary disease, they had a much higher mortality rate compared to people who had traditional risk factors explaining a heart attack,” she said.

In fact, patients who had no risk factors were almost 50 per cent more likely to die 30 days after a heart attack than people with risk factors.

And the impact was even worse for women.

“A woman who had a heart attack related to plaque in [her] arteries [with no risk factors] had a three times higher mortality [risk] than a male heart attack patient with risk factors,” Professor Figtree said.

“It shows we need to think beyond traditional risk factors to find out what is driving the increased heart attacks and mortality.”

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Research shows heart attacks more likely to be deadly among people with no risk factors.

Electrical disturbances may lead to attack

Heart disease and stroke are the biggest killers of Australian men and women.

It is estimated up to 15 per cent of people who have a heart attack do not have risk factors such as diabetes, smoking or obesity.

Professor Figtree said it seemed like heart attack patients without risk factors might be suffering higher rates of fatal heart rhythm complications.

“The biology that drives the susceptibility to heart disease in these individuals may actually unlock all sorts of information that helps us better understand the rest of the population at risk of heart disease,” she said.

Once Ms Tucker’s heart blockage was discovered, doctors inserted a stent to get the blood flowing and she made a full recovery.

Jennifer stands out the front of Sydney's Royal North Shore Hospital.
Jennifer Tucker had no heart attack risk factors, but she pushed for answers.(ABC News: Brendan Esposito)

Her message is simple.

“You have to take your health seriously and if you feel like you are not getting the answers from your GP, then keep pursuing it because you know when something is not right in your own body,” Ms Tucker said.

Professor Figtree is now leading more research, funded by the National Health and Medical Research Council, to find out why these risk-free heart attack patients are more likely to die and whether they can be identified much earlier.


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