Adjusted absolute riskA over a continuous period of renal failure, diabetes mellitus, dementia, depression and cancer after MI, compared to matched controlsb In England. ACalculated according to the standardized ICF, treating death without outcome as a competing risk, adjusted for non-linear age using restricted cubic splines, sex, calendar year and deprivation score and a time-dependent effect for MI compared to matched controls. Full CIF and CI by time point are provided in Table S5, and sensitivity analyses, in which follow-up was limited to beginning at least 2 months after study entry, are shown in Figure S2 and Table S6. The numbers at risk at 1, 5, and 9 years of follow-up are provided in Table S7. bIndividuals were matched based on a single year of age, sex, month and year of hospital admission, and NHS Trust using a 5:1 risk set matching approach. vsIncludes all types of cancer (ICD10 codes C00 to C97), i.e. this category is not limited to the sum of breast, prostate, lung and colorectal cancers). CI, confidence interval; CIF, cumulative incidence function; ICD, International Classification of Diseases; MI, myocardial infarction; NHS, National Health Service.
Having a heart attack significantly increases your risk of developing other serious long-term health problems, according to a major new study.
Researchers from the University of Leeds analyzed more than 145 million records covering every adult patient admitted to hospital over a nine-year period to establish the risk of long-term health problems following a heart attack, in the largest study of its kind.
Although heart attacks are a serious and life-threatening condition, the British Heart Foundation estimates that today more than seven in ten people survive them, provided they receive rapid, emergency treatment to get the blood flowing back to the heart muscle.
Yet previous research has shown that heart attacks can have health consequences for patients, including other conditions affecting the heart and circulatory system, but also conditions affecting other parts of the body and health problems. mental.
New research shows that patients who had a heart attack developed other diseases at a much higher rate than people of the same age and gender who had not had one.
Up to a third of patients developed heart or kidney failure, 7% had other heart attacks and 38% died from any cause during the nine-year study period.
Heart failure, atrial fibrillation, stroke, peripheral artery disease, severe bleeding, kidney failure, type 2 diabetes, and depression all occurred more frequently in people who had a heart attack than in those who did not have it, but the risk of cancer was lower overall. , and dementia risk did not differ overall.
The study also identified that people from lower socio-economic backgrounds were more likely to die or develop serious long-term health problems following a heart attack. In particular, people from more deprived backgrounds were more likely to develop heart and kidney failure than people from less deprived backgrounds and of the same age.
Lead author Dr Marlous Hall, Associate Professor of Cardiovascular Epidemiology at the Leeds School of Medicine and Multimorbidity Research at the Leeds Institute for Data Analysis (LIDA), said: “It There are around 1.4 million heart attack survivors in the UK who are at high risk. to develop other serious health problems.
“Our study provides accessible online information about the risk of these health problems for specific groups of age, gender and socioeconomic disadvantage so that people surviving a heart attack can be well informed about their future risks , to support informed health care decision-making with their doctor.”
“Effective communication about the likely course of the disease and the risk of long-term adverse effects between patients and healthcare professionals can promote positive lifestyle changes, encourage patients to adhere to treatment and improve patients’ understanding and quality of life.”
“Our study highlights the need to revise individual care plans to take into account the higher demand for care caused by survivorship.”
Researchers analyzed the records of all people aged 18 and over who were admitted to one of 229 NHS Trusts in England between January 1, 2008 and January 31, 2017. This represents 145,912,852 hospitalizations among 34,116 257 people. There have been 433,361 reports of people having a heart attack for the first time. The average age of heart attack patients was 67 years, and 66% of patients were men.
The study looked at 11 non-fatal health outcomes detailed below, as well as deaths from any cause, and compared the results to a control group of 2,001,310 people.
Health outcomes
Research has shown a significantly increased risk of developing certain conditions following a heart attack compared to the control group of patients.
It was most likely heart failure, since 29.6% of the study group developed the condition within nine years of their heart attack, compared to 9.8% of the control group during the same period. period.
Renal failure developed in 27.2% of patients in the study group, compared to 19.8% in the control group.
Some 22.3% of the study group developed atrial fibrillation, compared to 16.8% of the control group.
New hospitalization for diabetes was observed in 17% of the study group, compared to 14.3% of the control group.
The other conditions were:
- Severe bleeding – Study group: 19%; Control group: 18.4%
- Cerebrovascular disease – Study group: 12.5%; Control group: 11.6%
- Peripheral arterial disease – Study group: 6.5%; Control group: 4.06%
- Death from any cause – Study group: 37.8%; Control group: 35.3%
Overall, hospitalization records indicate that depression occurred in 8.9% of people after a heart attack, which was 6% more likely after a heart attack than in the control group. Women were more likely than men to develop depression after a heart attack, especially those who had their heart attack at a younger age. 21.5% of women who were under 40 at the time of their heart attack had records of hospitalization for depression, compared to 11.5% of men in the same age category.
There was no overall difference in the risk of dementia following a heart attack compared to the control group. Although the risk of vascular dementia was more likely in the study group, the difference observed was small (study group 2.3%; control group 2.1%).
Unlike other health outcomes, the research showed that cancer was less pronounced in the study group than in the control group. About 13.5% of the study group developed cancer after their heart attack, compared to 21.5% of the control group. Researchers believe many factors likely influence this finding, but the specific reasons for the decline in cancers after a heart attack remain unclear and require further research.
Morag Foreman, head of discovery researchers at Wellcome, said: “This research provides valuable information about the types of support and interventions that may be needed for patients following a heart attack, helping doctors and patients to make informed decisions during their recovery and beyond. »
“This research shows how cohort studies and analysis of large data sets can deepen our understanding of key health challenges and demonstrates the importance of supporting exploratory research in the area of population health and public health. As survival rates after a heart attack improve, understanding the longer-term impacts on physical and mental health is crucial.
Professor Bryan Williams, scientific and medical director of the British Heart Foundation, said: “Although more and more people are surviving a heart attack, longer-term consequences can occur. Particularly after a major heart attack, people can be left with irreparable damage. to their hearts, putting them at increased risk of heart failure.
“This study sheds additional light on how heart attacks are associated with an increased risk of developing other serious health problems, including heart failure and atrial fibrillation. It also found that people from backgrounds Lower socioeconomic status patients are at greater risk of additional health problems after a heart attack and at a younger age. Research suggests that these patients may benefit from additional support and monitoring to help reduce their risk to develop other health problems.
“It is essential that the NHS has the resources, including staff, infrastructure and equipment, to provide the care patients need to help them stay in the best possible health for longer.”
The work is published in the journal PLOS Medicine.
More information:
Marlous Hall et al, Health outcomes after myocardial infarction: population study of 56 million people in England, PLOS Medicine (2024). DOI: 10.1371/journal.pmed.1004343
Provided by the University of Leeds
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