Risk of Acute Myocardial Infarction After the Death of a Significant Person in One's Life: The Determinants of Myocardial Infarction Onset Study
Open accessAbstract
BACKGROUND: Acute psychological stress is associated with an abrupt increase in the risk of cardiovascular events. Intense grief in the days after the death of a significant person may trigger the onset of acute myocardial infarction (MI), but this relationship has not been systematically studied. METHODS AND RESULTS: We conducted a case-crossover analysis of 1985 participants from the multicenter Determinants of Myocardial Infarction Onset Study interviewed during index hospitalization for an acute MI between 1989 and 1994. We compared the observed number of deaths in the days preceding MI symptom onset with its expected frequency based on each patient's control information, defined as the occurrence of deaths in the period from 1 to 6 months before infarction. Among the 1985 subjects, 270 (13.6%) experienced the loss of a significant person in the prior 6 months, including 19 within 1 day of their MI. The incidence rate of acute MI onset was elevated 21.1-fold (95% confidence interval, 13.1-34.1) within 24 hours of the death of a significant person and declined steadily on each subsequent day. The absolute risk of MI within 1 week of the death of a significant person is 1 excess MI per 1394 exposed individuals at low (5%) 10-year MI risk and 1 per 320 among individuals at high (20%) 10-year risk. CONCLUSIONS: Grief over the death of a significant person was associated with an acutely increased risk of MI in the subsequent days. The impact may be greatest among individuals at high cardiovascular risk.
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The increased incidence of major depression, panic disorder, and posttraumatic stress disorder linked to bereavement and profound grief after the loss of a partner are at least partially mediated by OXT.
“As such, it seems likely that the increased incidence for major depression, panic disorder and posttraumatic stress disorder (Keyes et al., 2014), as well as the substantially increased risk of acute myocardial infarction (Mostofsky et al., 2012) linked to bereavement and profound grief after the loss of a partner, are also at least partially mediated by a”
From Hormonal contraceptives suppress oxytocin-induced brain reward responses to the partner’s face (2016) · cites this paper as Mostofsky et al., 2012
The Results report a 21.1-fold increase in acute myocardial infarction onset within 24 hours of the death of a significant person. The Discussion says none of the participants who lost a spouse did so within the day before MI onset, so the study does not establish that acute increase specifically after the loss of a partner. The citing sentence attributes the depression and other psychiatric-disorder claim to Keyes et al.; its proposed mediation is the citing authors’ inference, not a finding attributed to Mostofsky et al. (LLM, conf=0.88)
Experimental — accuracy not yet measuredInfarction linked to bereavement and profound grief after the loss of a partner is at least partially mediated by a disruption of OXT signaling.
“infarction (Mostofsky et al., 2012) linked to bereavement and profound grief after the loss of a partner, are also at least partially mediated by a disruption of OXT signaling (Hurlemann and Scheele, 2016).”
From Hormonal contraceptives suppress oxytocin-induced brain reward responses to the partner’s face (2016) · cites this paper as Mostofsky et al., 2012
The Results report a markedly elevated rate of myocardial infarction after the death of a significant person. But the study did not establish that acute infarctions followed the loss of a partner specifically: the Discussion says none of the participants who lost a spouse had done so within the prior day. It also did not measure profound grief. The OXT-signaling mechanism is attributed to a different citation in the citing sentence, not to Mostofsky et al. (LLM, conf=0.86)
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- Authors
- Mostofsky, E., Maclure, M., Sherwood, J. B., Tofler, G. H., Muller, J. E., & Mittleman, M. A.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Venue
- Circulation
- Published
- 2012-01-24
- Volume
- 125
- Issue
- 3
- Pages
- 491-496
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- PMC
- PMC3397171
- OpenAlex
- W2652168590
- Cited by
- 197
- References
- 26
- Citations by year
- 2026: 12 · 2025: 7 · 2024: 5 · 2023: 17 · 2022: 7 · 2021: 13 · 2020: 14 · 2019: 12 · 2018: 9 · 2017: 22 · 2016: 15 · 2015: 15 · 2014: 13 · 2013: 22 · 2012: 14
- FWCI
- 23.28
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (T32HL098048)
- National Institute of Allergy and Infectious Diseases (T32AI007535)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- acute myocardial infarction, bereavement, grief, psychological stress, acute stress response, cardiovascular risk, high cardiovascular risk
- MeSH terms
- Aged, Anger, Family, Female, Grief, Humans, Life Change Events, Male, Middle Aged, Myocardial Infarction, Nuclear Family, Risk Factors, Stress, Psychological, Models, Statistical, Widowhood, Cross-Over Studies
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