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Heart Attack Linked to Higher Risk of Other Health Conditions

News
Article

Heart failure, renal failure, atrial fibrillation and death are among the events that can happen years after a myocardial infarction.

People who have a heart attack are significantly more likely to develop other serious long-term health conditions in the decade following the episode, according to research published in the journal PLOS Medicine.1 The authors said the results show a need for more efforts aimed at preventing or limiting chronic diseases in patients who have had heart attacks.

According to data from the CDC, more than 800,000 people have a heart attack — known medically as myocardial infarction — every year in the United States, with more than 600,000 of them being a first heart attack.2 In order to determine health needs of individuals, it’s key to understand health outcomes of people with heart attack. But the long-term data on the impacts of heart attack on health outcomes is lacking.

“While more people than ever are surviving heart attacks, there can be longer term consequences,” Bryan Williams, chief scientific and medical officer at the British Heart Foundation, said in a release.3 "Particularly after a major heart attack, people can be left with irreparable damage to their heart, putting them at increased risk of heart failure.”

Investigators from the University of Leeds in England conducted a study to determine the long-term risk of major health outcomes following myocardial infarction and generate risk charts in order to inform care recommendations in the period after. Data on hospital episode statistic were gathered from the Admitted Patient Care data set and all-cause mortality data were gathered from the Office for National Statistics.

The study analyzed all-cause mortality and 11 non-fatal health outcomes, including subsequent myocardial infarction and first hospitalization for heart failure, atrial fibrillation, cerebrovascular disease, peripheral arterial disease, severe bleeding, renal failure, diabetes mellitus, dementia, depression, and cancer.

During the study period of January 2008 through January 2017, there were 14,5912,852 hospital episodes at NHS hospitals. Of those, 433,361 were people with myocardial infarction and 18,322 matched controls who went on to develop myocardial infarction. The mean age of those with myocardial infarction was 67.4 years, of which 283742 were male with a 30-day mortality rate of 9.9%. The matched controls had a similar age and sex profile.

Investigators found that after myocardial infarction, all-cause mortality was the most frequent event, followed by heart failure, renal failure, atrial fibrillation, severe bleeding, diabetes, cancer, cerebrovascular disease, depression, dementia, subsequent myocardial infarction, and peripheral arterial disease.

Additionally, compared with a risk-set matched population, first hospitalization of all non-fatal health outcomes were increased after myocardial infarction — with the exception of dementia and cancer.

“There are around 1.4 million heart attack survivors in the UK who are at high risk of developing further serious health conditions,” Marlous Hall, lead author on the study, said in a release.3 “Our study provides accessible online information of the risk of these health outcomes for specific age, sex and socioeconomic deprivation groups so that individuals surviving a heart attack can be well informed about their future risks, in order to support informed healthcare decision making with their doctor.”

Study limitations include a lack of access to diagnoses made in primary care, the reliance on ICD coding, which could have led to under reporting of certain conditions, and barriers to healthcare databases, such as timely data access, access to scalable computational facilities, and stringent data minimization.

“Effective communication of the likely course of disease and risk of adverse long-term outcomes between patients and healthcare professionals can promote positive lifestyle changes, encourage patients to stick to treatment, and improve patient understanding and quality of life,“ Hall said. “Our study highlights the need for individual care plans to be revised to take into account the higher demand for care caused by survivorship.”

References
1. Hall M, Smith L, Wu J, et al. (2024) Health outcomes after myocardial infarction: A population study of 56 million people in England. PLOS Medicine 21(2): e1004343. https://doi.org/10.1371/journal.pmed.1004343
2. Heart Disease Facts. Report. CDC. May 15, 2023. Accessed Feb. 19, 2024. https://www.cdc.gov/heartdisease/facts.htm
3. Tyler R. Heart attack significantly increases risk of other health conditions. News Release. British Heart Foundation. February 16, 2024. Accessed Feb. 19, 2024. https://www.bhf.org.uk/what-we-do/news-from-the-bhf/news-archive/2024/february/heart-attack-increases-risk-of-other-health-conditions

This story first appeared on Drug Topics.

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