People with acute coronary syndrome — a condition in which the heart’s blood supply is suddenly blocked —  have a higher risk of suicide, according to a study in the Journal of the American Heart Association.

Researchers identified 41,050 people 35 years or older in the National Mortality Registry in Taiwan who committed suicide in 2000-12 and compared them to 164,200 people with similar demographics.

After adjusting the data for diabetes, stroke, chronic kidney disease and psychiatric illness from the Health and Welfare Data Science Center in Taiwan, the researchers found that people with ACS were 200 percent more likely to commit suicide during the first six months after an ACS diagnosis.

After adjusting for other risk factors such as mental illness, the rate of suicide declined among ACS patients to about 15 percent higher risk.

Coronary heart disease and depression are two of the most critical causes of disability in countries with advanced economies. Numerous meta-analyses, prospective studies and systematic reviews have shown that depression is common in patients with ACS. But the studies haven’t revealed the association between ACS and suicide after adjusting for diabetes, stroke, chronic kidney disease and psychiatric illness.

In a 2008 science advisory, the American Heart Association recommended routine screening for depression in all patients with ACS. But implementing the recommendation remains insufficient in clinical settings, researchers said.

“We recommend that healthcare providers take the increased odds of suicide into their evaluation of patients newly diagnosed with ACS,” said Jung-Chen Chang, Ph.D., co-senior author of the study and assistant professor at the School of Nursing in the College of Medicine at National Taiwan University.

“In addition to the existing efforts for managing depressive symptoms and reducing suicide, all cardiologists should be aware of the potential associations between ACS and suicide and make necessary referrals to specialists for suicide prevention.”