The death of a spouse has been shown to increase the risk of death from cardiovascular disease, but whether the death of a significant person in one's life can trigger a myocardial infarction (MI) hasn't been systematically studied. Mostofsky and colleagues evaluated the risk of MI in the days after the death of a significant person among participants in the Determinants of MI Onset Study.

Of the 1,985 study subjects, 270 (14%) had experienced the death of a significant person in the six months preceding MI onset, including 19 who reported a death within one day of their MI. The study employed a crossover-control design, in which each patient served as her or his own control within the six months prior to enrollment, crossing over from control to case status at the time of the MI.

The rate of acute MI onset within 24 hours of learning of the death of a significant person was 21 times higher than it was one to six months after the death and declined over that first month. In terms of absolute risk, within one week of the death of a significant person, there would be one excess MI per 1,394 bereaved people with a low (5%) 10-year MI risk, one per 678 people with an intermediate (10%) risk, and one per 320 people with a high (20%) risk.

Although the death of a significant person is a rare event in a person's life, the authors note, the absolute risk of an MI in the week after that death is substantial. Providing social support and taking preventive measures, such as statin, low-dose aspirin, or [beta]-blocker therapy, may help mitigate the heightened risk.-KR

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