Both Lifestyle and Mortality Poor in ADHD Patients Post MI

TOPLINE:

Adults with myocardial infarction (MI) and attention-deficit/hyperactivity disorder (ADHD) were more likely to smoke, use snus, and have histories of bleeding and chronic obstructive pulmonary disorder (COPD) than those without ADHD. Although ADHD was associated with a higher rate of all-cause mortality, these patients were less likely to participate in follow-up evaluations or quit smoking after discharge.

METHODOLOGY:

• Researchers conducted an observational study using data from a Swedish registry to investigate the association between ADHD and cardiometabolic risk profiles in patients with acute MI and to assess its relevant implications.
• They included 582 patients diagnosed with ADHD and a matched cohort of 27src4 patients without ADHD (median age, 51 years; 77.4% men), all of whom experienced their first acute MI between January 2srcsrc6 and December 2src2src.
• Cardiometabolic risk profiles, including clinical parameters, disease histories, and behavioural factors, were analysed during the first acute MI hospitalisation. Further analysis included engagement in guideline-recommended non-pharmacologic interventions such as smoking cessation.
• Risks for recurrent cardiovascular events and cardiovascular disease and all-cause mortality were assessed over a median follow-up duration of 3.7 years for patients with MI and ADHD and 3.8 years for those without ADHD.

TAKEAWAY:

• No significant differences in most clinical parameters, except for total cholesterol levels, were observed between patients with MI and ADHD and those without ADHD. Moreover, those with MI and ADHD showed a higher risk for previous bleeding (risk ratio [RR], 1.88; 95% CI, 1.42-2.48) and COPD (RR, 2.35; 95% CI, 1.61-3.44) than those without ADHD.
• The risk for current smoking and snus use was 53% higher (RR, 1.53; 95% CI, 1.36-1.71) and 65% higher (RR, 1.65; 95% CI, 1.36-1.99), respectively, among patients with MI and ADHD than among those without ADHD.
• Patients with MI and ADHD were less likely to participate in follow-up evaluations (RR, src.87; 95% CI, src.79-src.96) and stop smoking after their first MI (RR, src.76; 95% CI, src.63-src.91).
• ADHD was associated with an increased rate of all-cause mortality (adjusted hazard ratio, 2.src2; 95% CI, 1.src5-3.88) after discharge, although no significant association was observed with recurrent cardiovascular events.

IN PRACTICE:

“[The study] findings suggest that integrating cardiology care with psychiatric services could enhance patient outcomes by providing coordinated treatment plans that address both cardiovascular and mental health needs,” the authors wrote.

SOURCE:

This study was led by Honghui Yao, Karolinska Institutet, Stockholm, Sweden. It was published online on April 11, 2src25, in the European Journal of Preventive Cardiology.

LIMITATIONS:

Only src.5% of patients with MI were diagnosed with ADHD, indicating potential underdiagnosis. Regular psychiatric visits for patients with ADHD may have led to an earlier detection and treatment of cardiometabolic problems. The matched sample included predominantly individuals who were diagnosed with first MI at a young age, thus limiting generalisability to older patients.

DISCLOSURES:

This study was supported by the European Union’s Horizon 2src2src research and innovation programme under grant agreement from the Swedish Research Council and Swedish Brain Foundation, the Swedish Heart-Lung Foundation, and other sources. Two authors reported receiving grants, personal fees, speaker fees, and sponsorships from various pharmaceutical companies, outside the submitted work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.