C-reactive protein as a predictor of posttraumatic stress induced by acute myocardial infarction.

Bielas, Hannes; Meister, Rebecca Elisabeth; Schmid, Jean-Paul; Barth, Jürgen; Znoj, Hansjörg; Schnyder, Ulrich; Princip, Mary; von Känel, Roland (2018). C-reactive protein as a predictor of posttraumatic stress induced by acute myocardial infarction. General hospital psychiatry, 53, pp. 125-130. Elsevier 10.1016/j.genhosppsych.2018.03.008

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BACKGROUND Acute coronary syndrome (ACS) may cause clinically relevant posttraumatic stress disorder symptoms (PTSS). An inflammatory state might be one mechanism linking PTSS with poor prognosis after ACS. We tested the hypothesis that a change in C-reactive protein (CRP) between hospital admission and 3-month follow-up is an independent predictor of ACS-triggered PTSS. METHODS We assessed 183 patients (median age 59 years; 84% men) with verified myocardial infarction (MI) within 48 h of an acute coronary intervention and three months post-MI for self-rated PTSS. 14 (7.7%) patients fulfilled definition criteria for PTSS caseness. CRP values were categorized according to the predicted risk of cardiovascular disease (CVD) at hospital admission (acute inflammatory response): 0 to <5 mg/L, 5 to <10 mg/L, 10 to <20 mg/L, and ≥ 20 mg/L; and at 3-month follow-up (low-grade inflammation): 0 to <1 mg/L, 1 to <3 mg/L, and ≥ 3 mg/L. Additionally, in a subsample of 84 patients with CRP levels below 20 mg/L at admission, CRP values were log-transformed. RESULTS After adjustment for covariates, less of a reduction or an increase of log CRP values between admission and 3-month follow-up predicted PTSS caseness (OR 6.25, 95% CI 1.25, 31.38), and continuous PTSS (unstandardized B = 0.21, 95% CI 0.07, 4.19; p = 0.043). Less reduction in CRP risk categories predicted both PTSS caseness (OR 4.14, 95% CI 1.89, 9.06) and continuous PTSS (B = 1.80, 95% CI 1.09, 2.51; p < 0.001). CONCLUSIONS Persistently heightened inflammation seems to be predictive for the development of PTSS three months after ACS, so interventions to lower inflammation might be warranted.

Item Type:

Journal Article (Original Article)

Division/Institute:

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
07 Faculty of Human Sciences > Institute of Psychology > Psychological and Behavioral Health
04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DCR Unit Sahli Building > Forschungsgruppe Neurologie

UniBE Contributor:

Meister, Rebecca Elisabeth; Znoj, Hans Jörg; Princip, Mary and von Känel, Roland

Subjects:

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

ISSN:

0163-8343

Publisher:

Elsevier

Language:

English

Submitter:

Stefanie Hetzenecker

Date Deposited:

14 Jun 2018 09:34

Last Modified:

22 Oct 2019 20:48

Publisher DOI:

10.1016/j.genhosppsych.2018.03.008

PubMed ID:

29880326

Uncontrolled Keywords:

Cardiovascular disease Inflammation Psychobiology Risk factor Trauma stress

BORIS DOI:

10.7892/boris.117198

URI:

https://boris.unibe.ch/id/eprint/117198

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