Acute stress disorder and C-reactive protein in patients with acute myocardial infarction.

Bielas, Hannes; Meister-Langraf, Rebecca E; Schmid, Jean-Paul; Barth, Jürgen; Znoj, Hans Jörg; Schnyder, Ulrich; Princip, Mary; von Känel, Roland (2018). Acute stress disorder and C-reactive protein in patients with acute myocardial infarction. European journal of preventive cardiology, 25(3), pp. 298-305. SAGE Publications 10.1177/2047487317748506

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Background Myocardial infarction-triggered acute stress disorder (ASD) and subclinical inflammation associate with the development of posttraumatic stress disorder, and worsen the prognosis of myocardial infarction patients. We examined the relationship between ASD severity and C-reactive protein levels in patients with acute myocardial infarction. Methods We assessed 190 patients (median age 59 years; 83% men) with a verified myocardial infarction within 48 h of an acute coronary intervention. Circulating levels of C-reactive protein were categorized according to their prognostic risk for cardiovascular disease: 0 to <5, 5 to <10, 10 to <20, and ≥ 20 mg/l. Patients completed the ASD-Scale (ASDS) for myocardial infarction-triggered symptoms and questionnaires for demographic factors, health behaviours, cardiac-related variables and psychosocial characteristics. Results The ASDS sum score was positively associated with C-reactive protein categories in the bivariate analysis ( r = 0.20, p < 0.01). Significant relationships with C-reactive protein also emerged for dissociation ( r = 0.25, p < 0.001) and avoidance ( r = 0.19, p < 0.01), but not for arousal and re-experiencing. Similarly, C-reactive protein levels ≥ 20 mg/l versus < 20 mg/l were predicted by the ASDS sum score, and the dissociation, avoidance and arousal subscores (all p-values < 0.05) in the fully adjusted binary regression analyses. C-reactive protein levels ≥ 20 mg/l were also independently predicted by male gender, body mass index, lower education, and lower left ventricular ejection fraction and higher white blood cell count. Conclusions Higher levels of myocardial infarction-triggered ASD symptoms associate with a greater inflammatory response in patients with acute myocardial infarction independently of important covariates. The findings suggest a link between myocardial infarction-triggered ASD symptoms and a heightened acute phase response with a potential impact on cardiovascular disease prognosis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology > Centre of Competence for Psychosomatic Medicine
07 Faculty of Human Sciences > Institute of Psychology > Clinical Psychology and Psychotherapy
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
07 Faculty of Human Sciences > Institute of Psychology

UniBE Contributor:

Znoj, Hans Jörg; Princip, Mary and von Känel, Roland

Subjects:

100 Philosophy > 150 Psychology
600 Technology > 610 Medicine & health

ISSN:

2047-4873

Publisher:

SAGE Publications

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

09 Jan 2018 09:41

Last Modified:

26 Oct 2019 07:48

Publisher DOI:

10.1177/2047487317748506

PubMed ID:

29243511

Uncontrolled Keywords:

Cardiovascular disease inflammation psychobiology risk factor trauma stress

BORIS DOI:

10.7892/boris.108156

URI:

https://boris.unibe.ch/id/eprint/108156

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