The CVC Cardiovascular Health Foundation (CVCF), in collaboration with the CVC, is pleased to name Dr. Arnav Agarwal as the third grant recipient of its inaugural Research Funding Program.
Following a peer-review process, Dr. Agarwal’s study was selected for its alignment with the program’s mission to advance CVC Faculty-led innovative projects, empower high-reward ideas, and address critical gaps in traditional research streams. Full details on the projects are outlined below:
Enhancing Risk Stratification for Type 2 Myocardial Infarction: Alberta Validation of the T2 Risk Score and Clinician Readiness for Risk-Guided Care
Unlike most heart attacks, which result from a sudden blockage in a coronary artery, some myocardial infarctions occur when the heart muscle does not receive enough oxygen during an acute illness, such as sepsis, severe anemia, low oxygen levels, or a rapid heart rhythm. This form of myocardial infarction, historically classified as a type 2 myocardial infarction (T2MI), and now described as secondary myocardial infarction under updated international definitions, is associated with a high risk of future cardiovascular events and death. However, management remains inconsistent, with limited evidence to guide which patients would benefit most from cardiac investigations, specialist assessment, preventive treatments, and follow-up.
The T2 Risk Score is a prediction model that uses routinely available clinical information to estimate a patient’s risk of another myocardial infarction or death within one year. Developed and validated in European populations, it has demonstrated better predictive performance than traditional acute coronary syndrome risk scores. However, it has not yet been validated in Canadian clinical practice.
With support from the CVC Foundation Research Funding Program, this two-phase project will evaluate the T2 Risk Score in Alberta and assess its potential to guide clinical care. First, investigators will validate the score using province-wide Connect Care and linked health system data, while examining variation in cardiac investigations, cardiology consultation, treatments, and follow-up across risk groups. Second, a case-based clinician survey will examine current decision-making, whether risk estimates influence intended management, and barriers and facilitators to adopting risk-guided care.
The project will provide Alberta-specific evidence on risk prediction and current care practices, while informing future integration of clinical decision support into Connect Care and the development of provincial care pathways. Ultimately, this work aims to support more consistent, evidence-informed care for patients with T2MI.
Principal Investigator: Dr. Arnav Agarwal
Co-Investigators: Drs. Justin Ezekowitz, Finlay McAlister, Pishoy Gouda, Michelle Graham, Robert Welsh, Shaun Goodman, Sean van Diepen, Darren Lau, Jennifer Ringrose, and Padma Kaul.
