Depression After Heart Attack Heightens Stroke Risk, Study Results Show

Analysis to be presented at the American College of Cardiology’s 71st Annual Scientific Session is based on the health records of 495,386 patients.

Individuals who had depression after suffering a heart attack were approximately 50% more likely to suffer a stroke compared with those who did not have depression, according to the results of a study presented at the American College of Cardiology’s 71st Annual Scientific Session.

Health records of approximately half a million US patients post-heart attack were analyzed for the study, and investigators found a major difference in stroke rates between patients with and without depression who otherwise had similar demographic and health backgrounds.

"The only difference between these 2 cohorts is that 1 has depression," lead study author Frank H. Annie, PhD, research scientist in the Department of Cardiology at Charleston Area Medical Center in Charleston, West Virginia, said in a statement.

"There could be a multitude of depression-related factors that are leading to these outcomes,” he said. “What we're seeing in this data is very troubling, and we need to dig deeper to understand the causes and effects."

Using the Trinetx database, the research team analyzed the health records of 495,386 patients who had heart attacks between 2015 and 2021. The database can pull electronic medical record data from 58 health care systems across the United States into a single, cloud-based service where investigators can analyze multiple sources of data while protecting patient privacy and security. In total, approximately 10.5% had a diagnosis of depression after their heart attacks. Further, about 1 in 6 of these patients had received diagnoses of mental health disorders before their heart attacks, while the others first received diagnoses of depression after their heart attacks.

Annie and his colleagues compared the data of 51,000 patients with depression to a group of heart attack survivors in the same data set who were well-matched in terms of other characteristics but did not have depression. The team found that 12% of those with depression and 8.3% of those without depression suffered a stroke afterward, which is about a 50% difference in stroke risk.

Multiple factors could have caused these differences, such as depression interfering with an individual’s ability to attend medical appointments and keep up with medications, according to the study authors.

Although the study showed that the link between depression and subsequent stroke was significant even after accounting for these variables, those who had depression were still susceptible to higher rates of chronic obstructive pulmonary disease, coronary artery disease, diabetes, heart failure, and hypertension.

The cause and effect involved in this study is unclear, but Annie said there is a lot of evidence that treatment for depression can help improve outcomes in those with heart disease.

"A multidisciplinary approach is required," Annie said. "Based on these data, if there's someone who has a history of heart disease and depression, I would advocate for devoting special attention within the health care system to making sure that these individuals are making their appointments and that they're seeing the right providers within the health system."

Future studies are required to further understand how depression and other factors may affect an individual’s heart health and risk of stroke, in addition to other forms of heart disease, according to the study authors.

Reference

Depression after a heart attack heightens stroke risk. American College of Cardiology. News release. March 23, 2022. Accessed March 29, 2022. https://www.acc.org/About-ACC/Press-Releases/2022/03/22/19/48/Depression-After-a-Heart-Attack-Heightens-Stroke-Risk#:~:text=In%20addition%2C%20new%20research%20finds,71st%20Annual%20Scientific%20Session