P358 Prevalence of suicide in a cohort of subjects submitted to exercise echocardiography: clinical characteristics and exercise echocardiography results

Abstract

Abstract Patients with clinical symptoms and morbidities might be more prone to commit suicide. Suicidal rate reaches up to 25-30/100.000 subjects in the countries most affected by this problem. We aimed to establish the rate of suicides among a large cohort of patients submitted to Exercise echocardiography (ExE), and also to study their clinical and ExE results, to better understand possible explanations. Methods Retrospective analysis of prospectively collected data on 12,615 patients (age 62 ± 12 years, 63% men) with a first treadmill ExE performed in our center for known/suspected coronary artery disease. Exclusion criteria were significant valve disease, cardiomyopathy, congenital heart disease, and age <18 year-old. Ischemia was defined as the development of new wall motion abnormalities (WMAs) with exercise; abnormal ExE as ischemia or resting WMAs. Results During a follow-up of 4.7± 4.8 years (interquartil range 0.1-8.0 years) there were 2,578 deaths, including 21 due to suicide (rate 166/100.000 subjects). We compare clinical characteristics and ExE results between patients that committed suicide (S), patients that died of other causes (OC), and patients that survived (Surv). The worst clinical and ExE characteristics were found in patients that died of non-suicidal causes, whereas patients that committed suicide were in an intermediate risk position (Table). In conclusion, suicidal rate seems to be very high among patients with a clinically indicated ExE. Clinical characteristics and ExE results of suicidal subjects are worse than in survivor patients and could in part explain this event. Surv S OC P value Age, y 61 ± 12 65 ± 11 69 ± 9 <0.001 Male 60% 86% 72% <0.001 Diabetes Mellitus 17.5% 24% 31% <0.001 Achieved METS 9.7 ± 3.2 8.3 ± 3.6 7.6 ± 2.9 <0.001 Good functional capacity (≥10 METs) 55% 52% 29% <0.001 Symptoms during ExE 16% 14% 19% 0.01 Maximal double product 25.0 ± 5.9 22.5 ± 6.4 22.9 ± 6.0 <0.001 Submaximal test 20% 31% 32% <0.001 Ischemia 27% 38% 44% <0.001 ExE abnormal 37% 50% 63% <0.001 LVEF at rest 59 ± 7 53 ± 13 54 ± 11 <0.001 LVEF at peak 64 ± 11 60 ± 16 55 ± 15 <0.001