ONCO-ACS Score Predicts Risks in Patients With Acute Coronary Syndrome and Cancer

TUESDAY, Feb. 10, 2026 (HealthDay News) — For patients with acute coronary syndrome (ACS) and cancer, the ONCO-ACS score predicts mortality, bleeding, and ischemic risk, according to a study published online Jan. 31 in The Lancet.

Florian A. Wenzl, M.D., from the National Disease Registration Service, National Health Service England, and colleagues conducted a model development and validation study using data for 1,017,759 patients who presented with ACS in England, Sweden, and Switzerland (36,771, 10,262, and 203 with cancer). Machine learning models were developed and validated externally in geographically distinct datasets (English Midlands, Sweden, and Switzerland).

The researchers found that patients with cancer and ACS had high rates of mortality, major bleeding, and ischemic events (cumulative incidence, 27.8, 7.3, and 16.1 percent, respectively); they also had a distinct risk profile. A single set of variables informed the ONCO-ACS score. On internal validation, ONCO-ACS showed a time-dependent area under the receiver operating characteristic curve (tAUC) at six months of 0.84, 0.70, and 0.79 for all-cause mortality, major bleeding, and ischemic events, accounting for traditional and cancer-related risk factors. ONCO-ACS achieved similar performance on external validation for all-cause mortality (tAUC at six months, 0.84, 0.80, and 0.83 for English Midlands, Sweden, and Switzerland), major bleeding events (0.70, 0.67, and 0.74, respectively), and ischemic events (0.76, 0.70, and 0.73, respectively).

“By accounting for both cancer and heart disease, ONCO-ACS marks a step towards truly personalized medicine,” senior author Thomas F. Lüscher, M.D., from the University of Zurich, said in a statement. “It can help doctors decide who benefits from invasive procedures and intensive drug therapy, and who may be at greater risk of harm.”

Several authors disclosed ties to the biopharmaceutical industry.

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