Patients who survive a heart attack have a significantly increased risk of developing a number of neurological and psychiatric disorders in the years following their discharge from hospital, according to a new study carried out by researchers from Aarhus University.

“The study shows that patients discharged after cardiac arrest have an increased risk of stroke, cerebral haemorrhage, epilepsy, dementia, depression and anxiety, even when compared with a group of patients who suffered coronary thrombosis,” explains Kasper Adelborg, medical doctor at the Regional Hospital in Gødstrup and associate professor at Aarhus University.

More people are surviving cardiac arrest

Every year, around 4,000 Danes suffer cardiac arrest, but the survival rate has improved in recent decades. While just four per cent survived cardiac arrest in 2001, in 2014 the figure was 13 per cent. This means that the number of patients who survive cardiac arrest is rising.

Smaller studies have previously found that patients who survive cardiac arrest have, inter alia, a higher mortality rate and increased risk of cognitive challenges. However, these studies were based on a limited number of subjects and a brief follow-up period.

The current study from Aarhus University includes all patients discharged after cardiac arrest in the period 1996 to 2016 – a total of over 12,000 patients – who were compared with 118,332 patients with coronary thrombosis and 120,460 people from the background population.

“We had a clear expectation that patients who had experienced cardiac arrest would have an increased risk of the outcomes studied compared to the background population, but the fact that this also showed up so clearly in patients who had suffered a blood clot in the heart was not expected,” says Kasper Adelborg.

Important information for patients and relatives

The increased risk of developing neurological and psychiatric disorders is greatest in the first year after discharge, and subsequently decreases over time.

During the first year after discharge, the risk of developing epilepsy is tripled among cardiac arrest patients, compared with the background population.

The study shows that the risk of developing disorders such as depression and anxiety is doubled.

After five years, the risk is at the same level as for patients who have survived coronary thrombosis. However, in relation to the general population, the risk remains elevated.

“If they get through the first year, this patient group is then more comparable to coronary thrombosis patients. This is important information for patients and their relatives,” says Kasper Adelborg.

Need for close monitoring

While the causes of the above-mentioned disorders are not yet fully understood, Kasper Adelborg believes that the current study clearly shows the need for increased attention to neurological and psychiatric complications for patients discharged from hospital after treatment for cardiac arrest.

“It may be worth considering whether there is a need for closer monitoring of patients discharged after cardiac arrest, similar to that offered to patients discharged after thrombosis,” he explains, adding:

“Systematic follow-up with attention to neurological and psychiatric complications will make it possible to prevent or initiate early treatment in these patients.”

The research result - more information

About the study: A nationwide cohort study examining the extent to which cardiac arrest patients are at increased risk of developing psychiatric and neurological disorders after discharge from hospital.

External funding: The Health Research Foundation of Central Denmark Region, the Lipmann Foundation, the Professor Sophus H. Johansen Foundation and the Danish Society of Anaesthesiology and Intensive Care Medicine Foundation.

Conflicts of interest?: Clinical Associate Professor Asger Granfeldt, co-author of the study, has received fees from DSMB Noorik Pharmaceuticals. Victor W. Henderson, professor at Stanford University, who also co-authored the study, has received a grant from the National Institutes of Health. Neither of these is related to the study. 

You can read the scientific article here. 

Contact: 

Kasper Adelborg, associate professor at the Department of Clinical Medicine at Aarhus University and medical doctor at the regional hospital in Gødstrup. 
kade@clin.au.dk
Tel.: (+45) 2034 1724