Key result
Unsupervised clustering of AMI patients identifies four distinct phenotypes with 1-year mortality up to ~16%.
Why the study?
Current classification of acute myocardial infarction into STEMI and NSTEMI does not fully reflect clinical heterogeneity, prompting unsupervised clustering to identify clinically meaningful phenotypes.
Does unsupervised clustering identify clinically meaningful phenotypes with distinct prognoses in patients with acute myocardial infarction?
Observational (n=4,947)
Yes
Does unsupervised clustering identify clinically meaningful phenotypes with distinct prognoses in patients with acute myocardial infarction?
Data-driven unsupervised clustering identifies four distinct acute myocardial infarction phenotypes that better reflect clinical heterogeneity and long-term prognosis than the traditional STEMI/NSTEMI dichotomy.
Answers are grounded in this paper and cite their sources.
May support phenotype-based AMI risk stratification; hypothesis-generating and requires prospective validation before clinical use.
Background Current classification of Acute Myocardial Infarction (AMI) into ST-elevation (STEMI) and non-ST-elevation (NSTEMI) myocardial infarction does not fully reflect the clinical heterogeneity of patients. Objectives To identify clinically meaningful phenotypes of AMI patients using an unsupervised clustering approach and assess their associations with management strategies and long-term outcomes. Methods Hierarchical agglomerative clustering using Ward’s method was performed in 4,947 patients from the French FAST-MI 2015 nationwide registry. Clustering was based on baseline clinical, demographic, and laboratory features. Between-cluster differences in baseline characteristics, management, in-hospital complications, and 1-year mortality were analyzed. Results Four phenotypic clusters were identified. Cluster 1 (n = 1,488) gathered older patients, predominantly men, with typical coronary risk factors, intermediate risk profile, and balanced STEMI/NSTEMI presentations. Cluster 2 ( n = 1,305) gathered older polymorbid patients, 45% were women, 60% with NSTEMI presentation, with limited use of invasive strategies (71%), and a high 1-year mortality. Cluster 3 (n = 815) gathered young (mean age 44 years), predominantly male patients, with a high prevalence of smoking (73%) and few comorbidities, 62% STEMI, high rates of revascularization, and excellent prognosis. Cluster 4 ( n = 1,339) was close to Cluster 3 with a more metabolic profile with higher rates of obesity, diabetes, and dyslipidemia, also with favorable outcomes. In-hospital complications were more frequent in Clusters 1 and 2. One-year mortality was lowest in Clusters 3 and 4 (1.5 and 2.3%), intermediate in Cluster 1 (6.0%), and highest in Cluster 2 (15.7%). Conclusion Unsupervised clustering identified four clinically relevant AMI phenotypes with distinct characteristics, management patterns, and prognoses. This data-driven classification highlights the diversity of AMI presentations and may offer complementary insights for patient profiling and risk stratification.
No takes yet. Share an insight, caveat, or question.
Bataille et al. (2026) conducted an observational in Acute Myocardial Infarction (n=4,947). Phenotypic clusters (Clusters 1-4) vs. Between-cluster comparison was evaluated on 1-year mortality (p=<0.001). Unsupervised clustering of patients with acute myocardial infarction identified four distinct clinical phenotypes with 1-year mortality rates ranging from 1.5% to 15.7%.
Synapse has enriched 10 related papers. Consider them for comparative context: