Department of General Practice, School of Public Health, Aarhus University, Aarhus, Denmark.
Circulation. 2010 Dec 7;122(23):2388-93. doi: 10.1161/CIRCULATIONAHA.110.956136. Epub 2010 Nov 22.
Myocardial infarction (MI) is associated with an increased risk of anxiety, depression, low quality of life, and all-cause mortality. Whether MI is associated with an increased risk of suicide is unknown. We examined the association between MI and suicide.
We conducted a population-based case-control study by retrieving data from 5 nationwide longitudinal registers in Denmark. As cases, we selected all persons aged 40 to 89 years who died by suicide from 1981 to 2006. As controls, we randomly selected up to 10 persons per case matched by sex, day of birth, and calendar time. We identified 19,857 persons who committed suicide and 190,058 controls. MI was associated with a marked increased risk of suicide. The risk of suicide was highest during the first month after discharge for MI for patients with no history of psychiatric illness (adjusted rate ratio, 3.25; 95% confidence interval, 1.61 to 6.56) and for patients with a history of psychiatric illness (adjusted rate ratio, 64.05; 95% confidence interval, 13.36 to 307.06) compared with those with no history of MI or psychiatric illness. However, the risk remained high for at least 5 years after MI.
MI is followed by an increased risk of suicide for persons with and without psychiatric illness. Our results suggest the importance of screening patients with MI for depression and suicidal ideation.
心肌梗死（MI）与焦虑、抑郁、生活质量降低和全因死亡率增加有关。心肌梗死是否与自杀风险增加有关尚不清楚。我们研究了心肌梗死与自杀之间的关系。
我们通过检索丹麦 5 个全国性纵向登记处的数据，开展了一项基于人群的病例对照研究。我们将 1981 年至 2006 年间死于自杀的所有 40 至 89 岁人群作为病例，将每个病例随机匹配 10 名性别、出生日期和日历时间相匹配的人作为对照。我们共确定了 19857 名自杀者和 190058 名对照者。心肌梗死与自杀的风险显著增加相关。对于无精神病史的患者（调整后的比率比，3.25；95%置信区间，1.61 至 6.56）和有精神病史的患者（调整后的比率比，64.05；95%置信区间，13.36 至 307.06），在 MI 出院后的第一个月内自杀的风险最高，与无 MI 或精神病史的患者相比。然而，MI 后至少 5 年内风险仍然很高。
无论有无精神病史，心肌梗死都会增加自杀的风险。我们的研究结果表明，对心肌梗死患者进行抑郁和自杀意念筛查的重要性。
