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American College of Cardiology's 64th Annual Scientific Session AM tip sheet

American College of Cardiology

The studies below will be presented at the American College of Cardiology's 64th Annual Scientific Session the morning of Saturday, March 14.

1. Depression May Influence Cardiovascular Outcomes

A new study adds to the evidence that depression may influence cardiovascular outcomes, prompting authors to call on cardiologists to pay closer attention to depression when managing patients with heart disease.

Researchers at Care Institute of Medical Sciences in India found depression to be independently associated with a greater chance of cardiovascular death and lower quality of life in areas such as overall well-being, emotional stability and physical activity. In fact, depressed patients had nearly double the risk of dying over the three-year study period compared with those who are not depressed. Being readmitted to the hospital or needing repeated angioplasty to open blocked arteries was unaffected by depression status. All told, 40 percent of 1,648 subjects studied had depression.

Keyur Parikh, M.D., lead study author, and his colleagues say this study, while limited to India, is among the first to examine the relationship between depression and rehospitalization, revascularization and death. Based on the results, clinicians have introduced yoga and cognitive behavioral therapy into ongoing cardiac rehab programs and plan to evaluate whether this might improve outcomes.

Parikh will present the study, "Depression and Outcome of Patients with Acute Coronary Syndrome: A 3 Year Follow-up Study," will be presented on Saturday, March 14 at 9:30 a.m. PT/12:30 p.m. ET/4:30 p.m. UTC in Poster Hall B1.

2. Heart Attack Survivors at Higher Risk for Certain Cancers

It's well known that cancer treatments, including chemotherapy and radiation therapy, may lead to future heart damage, but the opposite relationship--the risk of cancer among patients with heart disease--has not been considered. A new study out of Denmark suggests patients who survive their first heart attack may be at higher risk for cancer overall, and lung and bladder cancer in particular.

Using the Danish National Patient Registry, researchers identified 125,909 patients out of 3,005,734, who received a diagnosis of a heart attack for the first time and had no prior history of cancer. The cancer incidence was nearly double in survivors of heart attack compared with the background population--169 versus 95 per 10,000 people. Study authors say that the first six months following a heart attack showed a high risk of cancer and that this was most likely explained by increased surveillance during recovery. However, after six months patients remained at a 10 percent increased risk for cancer overall, a 50 percent increased risk for lung cancer and a 30 percent increased risk for bladder cancer when compared with the general population.

These results suggest that more focus on monitoring cancer risk among heart attack survivors may be warranted, said lead study author, Morten Winther Malmborg, research fellow, Gentofte Hospital, Copenhagen. More studies are needed to tease this apart and understand what might be contributing to the greater risk for lung and bladder cancers in particular. For now, researchers speculate it might be due to smoking, as this is a shared risk factor for both heart attack and these types of cancers. Other shared risk factors include alcohol use, obesity, physical inactivity and unhealthy eating.

Malmborg will present the study, "High Risk of Cancer Among Survivors of Myocardial Infarction: A Nationwide Study" on Saturday, March 14 at 9:30 a.m. PT/12:30 p.m. ET/4:30 p.m. UTC in Poster Hall B1.

3. Florida Hospital Sees Jump in Admissions for Heart Disease Amid Financial Crisis

There is more evidence that high levels of stress--in addition to well-known risk factors for heart disease--may play a role in the development of heart disease. A new study revealed a possible link between the financial crisis of 2008-2009 and a spike in hospital admissions for acute coronary syndromes at Jackson Memorial Hospital, a large safety-net hospital in South Florida.

Researchers compared the prevalence of acute coronary syndrome admissions before, during and after the financial crisis period, which was defined as the time interval between July 2008 and June 2009. Admissions for these conditions, which restrict blood flow to the heart, were significantly higher during the peak financial crisis compared to the year before or after. Data revealed 14.6 percent of total monthly admissions were due to diagnoses of acute coronary syndromes the year of the financial crisis, compared to 8.75 percent and 11.92 percent of patients before and after the crisis, respectively. Because this study is observational, it does not account for other patient variables.

Based on the data, Daniel Garcia, M.D., fellow and the study's lead author said, "it seems the financial crisis not only directly but also indirectly affected the economy due to increase of hospital admissions, length of hospital stay and more cardiovascular disease diagnosis and treatment, which are all very costly for society."

The findings were somewhat serendipitous as the research team was initially investigating associations between hurricanes and surges in heart-related admissions. But the boost in acute coronary syndrome seemed to align with the economic downfall. More research is needed.

Dr. Mohammad Ansari will present the study, "Time Correlation Between The American Financial Crisis Of 2008-2009 and an Increase In The Prevalence Of ACS Admissions," on Saturday, March 14 at 9:30 a.m. PT/12:30 p.m. ET/4:30 p.m. UTC in Poster Hall B1.


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