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Spouses face increased risk for mental issues after partner's AMI

Spouses of patients who experienced acute myocardial infarctions were at an elevated risk for depression, anxiety and suicide as a result of the event, according to study results published in the European Heart Journal. The risk was apparent even if the spouse’s partner survived.

More than 7 million people worldwide experience an acute myocardial infarction (AMI) every year.

“Bereavement literature is based on the event of losing a spouse, assuming that this effect applies to all types of fatal events and only fatal events,” the researchers wrote. “Yet the definition of bereavement may have to be expanded to include nonfatal events, and a better understanding of a nonfatal AMI’s effect on the spouse may support enhanced surveillance of adverse spousal psychological consequences.”

Emil L. Fosbøl, MD, PhD, a research fellow at Duke University, and colleagues used several Danish national registries to compare 16,506 spouses of patients who died of AMI with 49,518 spouses of patients who died of other causes. The researchers also compared two other samples of 44,566 spouses of patients with a nonfatal AMI and 131,563 spouses of patients hospitalized for nonfatal causes other than an AMI.

Fosbøl and colleagues obtained data on spousal use of antidepressants and benzodiazepines, as well as hospital admissions and ambulatory visits for depression and suicide.

More than three times the number of spouses of patients who died of an AMI had been using antidepressants in the year after the event vs. the year before (incidence rate ratio [IRR]=3.30; 95% CI, 2.97-3.68). Almost 50 times as many spouses used a benzodiazepine after a fatal AMI event compared with the year before (IRR=46.4; 95% CI, 42.2-50.9).

Those whose spouses sustained a nonfatal AMI were at greater risk for antidepressant and benzodiazepine initiation vs. spouses of patients hospitalized for reasons other than an AMI (P<.001). Spouses of patients who died of an AMI were also at increased risk for depression (P<.0001) and suicide (P=.07).

Among those who lost their spouse to an AMI, men were at greater risk for depression and suicide than women.

“This is a major public health issue for which there seems to be little awareness among doctors and policymakers,” Fosbøl said in a press release. “The most important finding of this study is that the system needs to consider the care needs for spouses, too, not only when a patient dies from an AMI, but also when the patient is ‘just’ admitted to the hospital with an AMI and survives. Previously, we did not have any data on those patients’ spouses where the patient survived the event.”

Disclosure: The study was supported by an award from the American Heart Association Pharmaceutical Roundtable and David and Stevie Spina. The researchers report no relevant financial disclosures.