Heart Attack Definition Overhauled for Women
Global cardiology groups have agreed on a new universal definition for heart attacks, specifically designed to improve diagnosis and treatment for women
Doctors have agreed on the world's first universal definition of a heart attack. This landmark move aims to end decades of women receiving worse care, a situation experts call systematic bias.
The agreement was announced at the European Society of Cardiology's annual congress in Munich. It was signed by the world's four leading cardiovascular health groups. For years, some less common heart attack types, which predominantly affect women, were coded as less important. This led to ineffective treatments and dangerous delays.
Professor Nicholas Mills of the University of Edinburgh led the international taskforce. He stated this is the first global alignment on diagnosing this critical condition. "It is a revolution. It's going to make care better for patients," Mills said.
Upgraded Attack Types
The new guidance upgrades three specific types of heart attack. These are up to ten times more common in women. They are often triggered by childbirth, exercise, or emotional stress. Previously, the most serious 'type 1' classification prioritized attacks caused by a clot. The types more common in women involve reduced blood flow for other reasons, like artery tears or spasms. These were often missed.
The three upgraded types are:
Changing Diagnostic Thresholds
A crucial change involves the blood test for troponin, a protein released when the heart is injured. Until now, women had to reach the same threshold as men to get a diagnosis. Professor Mills called this an "unintended systematic bias." The new guidelines will lower the diagnostic threshold for women. This aims to ensure the test, used in every emergency department globally, picks up all cases.
Professor Bryan Williams of the British Heart Foundation hailed the shift. "This is a landmark moment," he said. "For decades, women have missed out. This focus on less common causes, which predominantly affect women, should help to change that." He added that the new, streamlined categories will also help patients understand the cause of their heart attack.
The guidelines were published in the European Heart Journal. The taskforce included the European Society of Cardiology, the American College of Cardiology, the American Heart Association, and the World Heart Federation. Their job now is global implementation. Mills emphasized it is just as relevant for the UK as anywhere else.
