Higher Risk of Myocardial Infarction, Heart Failure, and Atrial Fibrillation Noted After Spinal Cord Injury

There are several factors which increase the risk of cardiovascular disease in survivors of spinal cord injury. They have a greater prevalence of obesity, dyslipidemia, metabolic syndrome and diabetes mellitus. Energy expenditure is lesser both due to lack of motor function and lack of opportunities to engage in physical activity. Autonomic dysfunction caused by spinal cord injury is associated with abnormalities in blood pressure, heart rate variability, arrhythmias and blunted cardiovascular response to exercise which can limit the capacity to perform physical activity [1].

A recent large study from Korea compared over 5000 survivors of spinal cord injury with matched controls. Higher risk of myocardial infarction, heart failure and atrial fibrillation was noted in spinal cord injury survivors compared to controls. Survivors with severe disability had the highest risk. Cervical and lumbar injury survivors had increased risk of heart disease regardless of disability, though it was slightly higher in those with disability. Thoracic spinal cord injury survivors with disability had significantly increased risk of heart disease compared to matched controls [2]. The finding of excess risk in lumbar injuries was an unexpected finding in the study.

References

1. Myers J, Lee M, Kiratli J. Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management. Am J Phys Med Rehabil. 2007 Feb;86(2):142-52. doi: 10.1097/PHM.0b013e31802f0247. PMID: 17251696.
2. Yoo JE, Kim M, Kim B, Lee H, Chang WH, Yoo J, Han K, Shin DW. Increased Risk of Myocardial Infarction, Heart Failure, and Atrial Fibrillation After Spinal Cord Injury. J Am Coll Cardiol. 2024 Feb 20;83(7):741-751. doi: 10.1016/j.jacc.2023.12.010. PMID: 38355244.