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Chronic Distress After Heart Attack Ups Risk for Death

THURSDAY, June 20, 2019 -- Heart attack survivors with persistent emotional distress -- depression or anxiety -- are at a higher risk for death, according to a study published online June 3 in the European Journal of Preventive Cardiology.

Claudia T. Lissåker, from Uppsala University in Sweden, and colleagues used data from the national SWEDEHEART register to identify 57,602 consecutive patients with a first-time myocardial infarction. Emotional distress was assessed two and 12 months after the myocardial infarction. Patients' emotional distress was characterized as persistent (emotional distress at both time points), remittent (emotional distress at the first follow-up only), new (emotional distress at the second-follow up only), or no distress.

The researchers found that patients with persistent emotional distress were more likely to die from cardiovascular (hazard ratio, 1.46) and noncardiovascular causes (hazard ratio, 1.54) compared with patients with no distress. There was no significant association between remittent emotional distress and increased risk for death from any cause compared with no emotional distress.

"Among patients who survive 12 months, persistent, but not remittent, emotional distress was associated with increased cardiovascular and noncardiovascular mortality," the authors write. "This indicates a need to identify subgroups of individuals with emotional distress who may benefit from further assessment and specific treatment."

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Posted: June 2019

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