Recurrent heart attacks on the decline, yet risk remains high

September 21, 2020

DALLAS, Sept. 21, 2020 -- After surviving a heart attack, the proportion of patients who experience a repeat attack within a year fell between 2008 and 2017, with a greater decline in women than men, according to new research published today in the American Heart Association's flagship journal Circulation.

Despite the improvement, the rate of recurrent heart attacks, hospitalization for heart failure, and death remains high in heart attack survivors.

"Secondary events after a heart attack may be prevented by ensuring that patients receive guideline-recommended treatments to lower the risk for recurrent heart disease and death after hospital discharge," said Sanne A. E. Peters, Ph.D., lead author of the study and senior lecturer at The George Institute for Global Health in collaboration with Imperial College London, United Kingdom.

While the number of people dying from a heart attack has decreased substantially over the past few decades, those who survive are at increased risk to experience another heart attack or to die within a year after they leave the hospital. To examine the change in rates and compare the changes in men and women, researchers used data from Medicare and commercial health insurers on more than 770,000 women and more than 700,000 men who were hospitalized for a heart attack between 2008 and 2017. Researchers looked at the rates of recurrent heart attacks, procedures to open clogged heart arteries and hospitalizations to treat heart failure during the first year after hospital discharge following a heart attack. Among Medicare patients, the rate of death from all causes was also tracked.

The researchers found that between 2008 and 2017, the age-adjusted rates (in terms of the number per 1,000 person-years):"Improvements in the emergency treatment of heart attacks and better treatment options for people who survive a heart attack may explain the overall decline," Peters said.

As for the lack of decline in recurrent heart attacks in younger women and older men, Peters said they don't know why the rates were different in these populations, "In women, it could be that younger women and their treating physicians may be more likely to miss signs of worsening heart disease."

For recurrent heart attack, recurrent heart disease events, and heart failure hospitalizations, there was a proportionately greater reduction over time in women than men. The sex differences persisted in the most recent year studied. In 2017, there were higher rates of heart attack and heart disease events and death in men, but higher rates of heart failure hospitalization among women. These rates were adjusted for multiple variables including age, race and various medical conditions and treatments.

"We expected to see a decline in the rate of events, however, we did not expect the rates to differ between the sexes. It may be that the improvements in men were achieved before our study period, leaving less room for improvement in the most recent decade. It could also be that the attention paid to heart disease in women over recent years has resulted in the greater gains. However, regardless of the improvements, the rates of recurrent events in people who survived a heart attack are still very high in both sexes. Patients should speak with their doctors to ensure that the get the right treatments to prevent secondary events and must make sure that they adopt or maintain a healthy lifestyle," said Peters.

While the database used in the study was large, multi-ethnic and included a wide age range, findings from these insured groups may not be generalizable to the overall population. The study is also limited because the data sources do not include information on the severity of heart attack, so the reduction in repeat attacks over time might reflect a reduced severity of the initial attacks.
-end-
Co-authors are Lisandro D. Colantonio, M.D., Ph.D.; Ligong Chen, Ph.D.; Yuling Dai, M.S.P.H.; Hong Zhao, Ph.D.; Vera Bittner, M.D., M.S.P.H.; Michael E. Farkouh, M.D., M.Sc.; Paul Dluzniewski, Ph.D.; Bharat Poudel, M.S.P.H.; Paul Muntner, Ph.D.; and Mark Woodward, Ph.D.

This analysis was funded by an industry/academic collaboration between Amgen, Inc. and the University of Alabama at Birmingham.

Additional Resources:

Available multimedia is on right column of release link - https://newsroom.heart.org/news/recurrent-heart-attacks-on-the-decline-yet-risk-remains-high?preview=bf48b5ccf3751e46f041ecb8e833b5d4

After 4 a.m. CT/ 5 a.m. ET, Monday, Sept. 21, view the manuscript online.

Proactive steps can reduce chances of second heart attack
Warning signs of heart failure
Follow AHA/ASA news on Twitter @HeartNews
Follow news from the AHA's flagship journal Circulation@CircAHA

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the Association's policy or position. The Association makes no representation or guarantee as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.