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 Acute coronary syndrome, which includes problems ranging from a
heart attack to a type of chest pain called unstable angina, has
previously been linked with depression and an increased risk of poor
health and death, the researchers write in the Journal of the
American Heart Association.
Researchers had not thoroughly looked for a link between acute
coronary syndrome and suicide, however.
For the new study, Dr. Chao-Han Liu of the Institute of Applied
Science and Technology in Taipei and colleagues analyzed data on
41,050 people age 35 or older who died from suicide between 2000 and
2012, and 164,200 people who did not take their own lives.
In the suicide group, the rate of acute coronary syndrome was 2.5
percent, compared with 1.5 percent in the comparison group.
After adjusting the results to account for factors that may
influence the risk of suicide, such as mental health issues and
other health conditions, people with acute coronary syndrome were
still 15 percent more likely to take their own lives than people
without this condition.
The increased risk of suicide persisted for four years but was
especially high immediately following the heart patients' health
scares. For these patients, the risk of suicide was three times
higher during the six months after their diagnosis than it was for
the comparison group, the researchers found.
The risk of suicide also increased with age and with frequency of
healthcare system use.
Donald Edmondson, director of the Center for Behavioral
Cardiovascular Health at Columbia University Medical Center in New
York City, told Reuters Health the study's data are strong and
people should pay attention to the results.
While emergency department physicians and cardiologists are becoming
aware of the psychological impact of cardiac events, there is not
enough information yet to say what might lead patients to suicide,
said Edmondson, who wasn't involved with the new study.
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"We should be careful about the management of depression after a
heart attack," said Dr. Samir Kapadia, who is a cardiologist and
section head of interventional cardiology at the Cleveland Clinic in
Ohio.
"Maybe people taking care of depressed patients should also ask them
about chest pain and heart problems, because they go hand in hand,"
said Kapadia, who also wasn't involved with the new research.
People feeling depressed after a diagnosis of acute coronary
syndrome should feel free to open up to their doctors so they can be
treated, Kapadia told Reuters Health.
Edmondson said family and friends should also be aware and prepared
to connect patients with the appropriate resources, if necessary.
"Even though your husband, wife or whoever had one of these events
and is going to be fine in terms of cardiovascular health and
longevity, they may not be able to tell you the true psychological
impact it’s having," he said.
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