Younger heart attack survivors who experience feelings of depression or anxiety are more than twice as likely to have subsequent cardiovascular (CV) events within five years, according to new data scheduled to be presented May 16 at ACC.21, the American College of Cardiology’s 70th annual scientific session.

The authors tracked data from 283 patients between the ages of 18 and 61 who survived a myocardial infarction (MI). The average patient age was 51 years old. Within five years, 80 of those patients had experienced another adverse cardiovascular event. Examples of such events were repeat MIs, strokes, hospitalizations for heart failure or deaths from cardiovascular complications.

Adverse events occurred in 47% of patients who reported feeling high distress after their initial MI. On the other hand, they occurred in just 22% of patients who said they only experienced mild distress.

In addition, the researchers noted, patients who felt high distress after that initial MI were more likely to be Black, female or come from a “disadvantaged socioeconomic background.” They were also more likely to smoke, have diabetes or elevated blood pressure.

“Our findings suggest that cardiologists should consider the value of regular psychological assessments, especially among younger patients,” lead author Mariana Garcia, MD, a cardiology fellow at Emory University in Atlanta, said in a prepared statement. “Equally importantly, they should explore treatment modalities for ameliorating psychological distress in young patients after a heart attack, such as meditation, relaxation techniques and holistic approaches, in addition to traditional medical therapy and cardiac rehabilitation.”