Non-fatal cardiovascular outcome in patients with posttraumatic stress symptoms caused by myocardial infarction

von Känel, Roland; Hari, Roman; Schmid, Jean Paul; Wiedemar, Lina; Guler, Erika; Barth, Jürgen; Saner, Hugo; Schnyder, Ulrich; Begré, Stefan (2011). Non-fatal cardiovascular outcome in patients with posttraumatic stress symptoms caused by myocardial infarction. Journal of cardiology, 58(1), pp. 61-68. Tokyo: Elsevier 10.1016/j.jjcc.2011.02.007

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Objectives Posttraumatic stress disorder (PTSD) prospectively increases the risk of incident cardiovascular disease (CVD) independent of other risk factors in otherwise healthy individuals. Between 10% and 20% of patients develop PTSD related to the traumatic experience of myocardial infarction (MI). We investigated the hypothesis that PTSD symptoms caused by MI predict adverse cardiovascular outcome. Methods We studied 297 patients (61 ± 10 years, 83% men) who self-rated PTSD symptoms attributable to a previous index MI. Non-fatal CVD-related hospital readmissions (i.e. recurrent MI, elective and non-elective intracoronary stenting, bypass surgery, pacemaker implantation, cardiac arrhythmia, cerebrovascular event) were assessed at follow-up. Cox proportional hazard models controlled for demographic factors, coronary heart disease severity, major CVD risk factors, cardiac medication, and mental health treatment. Results Forty-three patients (14.5%) experienced an adverse event during a mean follow-up of 2.8 years (range 1.3–3.8). A 10 point higher level in the PTSD symptom score (mean 8.8 ± 9.0, range 0–47) revealed a hazard ratio (HR) of 1.42 (95% CI 1.07–1.88) for a CVD-related hospital readmission in the fully adjusted model. A similarly increased risk (HR 1.45, 95% CI 1.07–1.97) emerged for patients with a major or unscheduled CVD-related readmission (i.e. when excluding patients with elective stenting). Conclusions Elevated levels of PTSD symptoms caused by MI may adversely impact non-fatal cardiovascular outcome in post-MI patients independent of other important prognostic factors. The possible importance of PTSD symptoms as a novel prognostic psychosocial risk factor in post-MI patients warrants further study.

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
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

von Känel, Roland; Barth, Jürgen; Saner, Hugo and Begré, Stefan

ISSN:

0914-5087

Publisher:

Elsevier

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:21

Last Modified:

14 Oct 2017 18:21

Publisher DOI:

10.1016/j.jjcc.2011.02.007

PubMed ID:

21493042

Web of Science ID:

000292902500009

BORIS DOI:

10.7892/boris.7200

URI:

https://boris.unibe.ch/id/eprint/7200 (FactScience: 212385)

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