Clinical Report: Suicide Risk in Atherosclerotic Cardiovascular Disease Patients
Overview
A nationwide Korean study reveals a 43% increased suicide risk among individuals with atherosclerotic cardiovascular disease (ASCVD), with an 85% increase in those having both myocardial infarction and stroke. This highlights the critical intersection of cardiology and mental health, emphasizing the need for integrated suicide risk assessment in cardiovascular care.
Background
Suicide is a leading preventable cause of death globally, with particularly high rates in South Korea. Depression, prevalent among cardiovascular disease (CVD) patients, is a strong predictor of suicide and complicates disease management. The bidirectional relationship between depression and CVD underscores the importance of addressing mental health in cardiology. Despite this, suicide risk remains underrecognized in cardiology guidelines.
Data Highlights
Group
Suicide Risk Increase
Notes
ASCVD (MI or Stroke)
43%
Compared to matched controls over median 11.3 years
Both MI and Stroke
85%
Highest risk subgroup (3.3% of ASCVD cohort)
Key Findings
Individuals with ASCVD have a 43% higher risk of suicide compared to controls.
Concurrent myocardial infarction and stroke increase suicide risk by 85%.
Elevated suicide risk persists across sex, age groups, and regardless of prior depression diagnosis.
Psychological distress after ASCVD may extend beyond formal psychiatric diagnoses, including anxiety, trauma, and hopelessness.
Biological, psychological, and socioeconomic factors contribute to the increased suicide risk post-ASCVD.
Systematic mental health screening should be integrated into cardiovascular care, especially during hospitalization, post-discharge follow-up, and cardiac rehabilitation. Recognizing psychological distress and vulnerability phenotypes beyond formal psychiatric diagnoses can enable earlier intervention and targeted support. Cardiac rehabilitation programs offer a valuable opportunity to improve mood and reduce suicide risk but remain underutilized for mental health screening.
Conclusion
The study underscores the overlooked but significant link between ASCVD and suicide risk, advocating for a holistic approach that incorporates mental health assessment into cardiology practice to prevent avoidable deaths.
