Is It Safe to Drive After a Heart Attack? New Study Says

A recent study highlights that current guidelines advising patients on when to resume driving after an ST-segment elevation myocardial infarction (STEMI) may be outdated. The findings emphasize the importance of updating recommendations, given the personal and economic impact of driving restrictions.

Key Findings from the DRIVE-STEMI Study

The DRIVE-STEMI study examined the risks patients face within the first year after hospital discharge. Results showed that the overall risk of death remained below 5%, with a low incidence of serious cardiac events such as cardiac arrest, syncope (fainting), stroke, recurrent heart attacks, and hospitalization due to heart rhythm disturbances.

This study was first presented at the American College of Cardiology (ACC) 2024 Scientific Session and later published in Circulation on January 21, 2025.

New Approach: Sudden Cardiac Incapacitation

The DRIVE-STEMI study is the first to use a broader measure called “sudden cardiac incapacitation” to assess driving safety. Researchers, led by Dr. Luiz F. Ybarra from Western University, Canada, analyzed data from 24,890 STEMI patients discharged between April 2017 and March 2021. The patients had an average age of 63 years, with 27% being women.

Major Findings from the Study

The study revealed the following statistics within the first year after discharge:

4.9% of patients passed away.
0.6% experienced cardiac arrest.
1.7% had fainting episodes (syncope).
0.7% suffered a stroke.
2.7% had another heart attack (myocardial infarction).
2.1% required hospitalization or emergency care for serious arrhythmias.
0.3% were treated for a specific type of dangerous heart rhythm (ventricular tachyarrhythmia).

Timing of Cardiac Events

Notably, most cardiac events occurred within the first 15 days following discharge. The study also identified two key outcome measures:

Primary Composite Endpoint – This included death, cardiac arrest, syncope, stroke, heart attack, and arrhythmia-related hospitalizations, affecting 11% of patients in one year.
Secondary Composite Endpoint – This included death, cardiac arrest, syncope, stroke, or sustained ventricular tachyarrhythmia, occurring in 7.4% of patients.

Differences by Age Group

Age played a significant role in patient outcomes:

Younger patients (≤65 years):
- Primary endpoint occurred in 6.7% of cases.
- Secondary endpoint was observed in 3.9%.
Older patients (>65 years):
- Primary endpoint rose to 16.8%.
- Secondary endpoint was recorded in 12.1%.
The main driver of this difference was a higher all-cause mortality rate in older individuals (9.1% compared to 1.9% in younger patients).

Proposed Changes to Driving Restriction Guidelines

Based on these findings, the researchers recommend updating driving restrictions as follows:

For all patients: A one-month driving restriction is suggested based on the primary endpoint.
For younger patients: A two-week restriction appears sufficient, with no restriction needed based on the secondary endpoint.
For older patients: Since most differences were due to general mortality rather than heart-related risks, the actual driving restriction may be shorter than current guidelines suggest.

Conclusion: Time for an Update in Driving Guidelines?

The DRIVE-STEMI study suggests that existing recommendations for resuming driving after a STEMI may be unnecessarily strict. By focusing on sudden cardiac incapacitation rather than just sudden cardiac death, the study provides a clearer picture of risk. As a result, younger patients might safely resume driving sooner, and older patients may not require as long a restriction as previously thought. This study could help shape more precise, evidence-based guidelines that balance patient safety with personal and economic considerations.

Source: Inputs from various media Sources

I’m a pharmacist with a strong background in health sciences. I hold a BSc from Delhi University and a pharmacy degree from PDM University. I write articles and daily health news while interviewing doctors to bring you the latest insights. In my free time, you’ll find me at the gym or lost in a sci-fi novel.