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Cited by 400Cardiac Health and Mental HealthPosttraumatic Stress Disorder ResearchAcute Myocardial Infarction Research

The DOI matches its Crossref record; 67 of the 67 references it cites were found in a registry or an index.

Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review.

Open access
Edmondson, Donald, Richardson, Safiya, Falzon, Louise, Davidson, Karina W., Mills, Mary Alice, Neria, Yuval·2012·PLoS ONE
DOI 10.1371/journal.pone.0038915PMC PMC3380054
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Abstract

BACKGROUND: Acute coronary syndromes (ACS; myocardial infarction or unstable angina) can induce posttraumatic stress disorder (PTSD), and ACS-induced PTSD may increase patients' risk for subsequent cardiac events and mortality. OBJECTIVE: To determine the prevalence of PTSD induced by ACS and to quantify the association between ACS-induced PTSD and adverse clinical outcomes using systematic review and meta-analysis. DATA SOURCES: Articles were identified by searching Ovid MEDLINE, PsycINFO, and Scopus, and through manual search of reference lists. METHODOLOGY/PRINCIPAL FINDINGS: Observational cohort studies that assessed PTSD with specific reference to an ACS event at least 1 month prior. We extracted estimates of the prevalence of ACS-induced PTSD and associations with clinical outcomes, as well as study characteristics. We identified 56 potentially relevant articles, 24 of which met our criteria (N = 2383). Meta-analysis yielded an aggregated prevalence estimate of 12% (95% confidence interval [CI], 9%-16%) for clinically significant symptoms of ACS-induced PTSD in a random effects model. Individual study prevalence estimates varied widely (0%-32%), with significant heterogeneity in estimates explained by the use of a screening instrument (prevalence estimate was 16% [95% CI, 13%-20%] in 16 studies) vs a clinical diagnostic interview (prevalence estimate was 4% [95% CI, 3%-5%] in 8 studies). The aggregated point estimate for the magnitude of the relationship between ACS-induced PTSD and clinical outcomes (ie, mortality and/or ACS recurrence) across the 3 studies that met our criteria (N = 609) suggested a doubling of risk (risk ratio, 2.00; 95% CI, 1.69-2.37) in ACS patients with clinically significant PTSD symptoms relative to patients without PTSD symptoms. CONCLUSIONS/SIGNIFICANCE: This meta-analysis suggests that clinically significant PTSD symptoms induced by ACS are moderately prevalent and are associated with increased risk for recurrent cardiac events and mortality. Further tests of the association of ACS-induced PTSD and clinical outcomes are needed.

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Crossref · 10.1371/journal.pone.0038915

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Figure 1 Search strategy flowchart.
Figure 1 Search strategy flowchart.CC BY · PubMed Central
Figure 2 ACS-induced PTSD prevalence estimates. Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.
Figure 2 ACS-induced PTSD prevalence estimates. Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.CC BY · PubMed Central
Figure 3 Funnel plot to assess publication bias across prevalence studies.
Figure 3 Funnel plot to assess publication bias across prevalence studies.CC BY · PubMed Central
Figure 4 ACS-induced PTSD prevalence estimates by diagnostic interview or screening questionnaire. Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.
Figure 4 ACS-induced PTSD prevalence estimates by diagnostic interview or screening questionnaire. Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.CC BY · PubMed Central
Figure 5 Association of ACS-induced PTSD with adverse clinical outcome. Note: The size of the box associated with each study’s estimate represents the precision of the estimate, and the line represents the confidence interval around the estimate.
Figure 5 Association of ACS-induced PTSD with adverse clinical outcome. Note: The size of the box associated with each study’s estimate represents the precision of the estimate, and the line represents the confidence interval around the estimate.CC BY · PubMed Central
Figure 6 Funnel plot to assess publication bias across outcome studies.
Figure 6 Funnel plot to assess publication bias across outcome studies.CC BY · PubMed Central

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Citations

Cites

Show all 67 references

Research works printed but not linked: 7

  1. JK Neumann, 1991, Psychological post-traumatic effects of MI: A comparison study., Medical Psychotherapy: An International Journal, 4, 105
  2. D Edmondson, 2011, Posttraumatic stress due to an acute coronary syndrome increases risk of 42-month major adverse cardiac events and all-cause mortality., 10.1016/j.jpsychires.2011.07.004 · DOI
  3. BM Lukach, 1996, Are heart attacks traumatic stressors?, Diss Abstr Int: Section B: The Sciences and Engineering, 56, 6398
  4. ML Gander, 2006, Myocardial infarction and post-traumatic stress disorder: frequency, outcome, and atherosclerotic mechanisms., Eur J Cardiovasc PrevRehabil, 13, 165, 10.1097/01.hjr.0000214606.60995.46 · DOI
  5. E Guler, 2009, Clinical diagnosis of posttraumatic stress disorder after myocardial infarction., Clin Cardiol, 32, 125, 10.1002/clc.20384 · DOI
  6. LA Doerfler, 2005, Relationship of quality of life and perceived control with posttraumatic stress disorder symptoms 3 to 6 months after myocardial infarction., J Cardiopulm Rehabil, 25, 166, 10.1097/00008483-200505000-00008 · DOI
  7. A Wikman, 2008, Persistence of posttraumatic stress symptoms 12 and 36 months after acute coronary syndrome., Psychosom Med, 70, 764, 10.1097/PSY.0b013e3181835c07 · DOI

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Metadata

Authors
Edmondson, D., Richardson, S., Falzon, L., Davidson, K. W., Mills, M. A., & Neria, Y.
Affiliations
  • Columbia University Irving Medical Center (US)
  • VA Boston Healthcare System (US)
Corresponding author
Edmondson, Donald
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2012-06-20
Volume
7
Issue
6
Pages
e38915
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0038915
PMC
PMC3380054
OpenAlex
W2078373966
Cited by
400
References
67
Citations by year
2026: 20 · 2025: 25 · 2024: 35 · 2023: 25 · 2022: 35 · 2021: 28 · 2020: 36 · 2019: 44 · 2018: 32 · 2017: 25 · 2016: 23 · 2015: 35 · 2014: 17 · 2013: 19 · 2012: 1
FWCI
3.78
Type
journal article
Language
en
Update notices
correction (2019-03-06)
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Columbia Academic Commons (Columbia University)
Funders
  • Georgia Clinical and Translational Science Alliance (UL1RR024156)
  • National Institutes of Health
  • National Heart, Lung, and Blood Institute (HL088117, P01HL088117)
  • National Cancer Institute (CA-156709, KM1CA156709)
  • National Center for Research Resources (UL1RR024156)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
post-traumatic stress disorder, acute coronary syndrome, myocardial infarction, unstable angina, PTSD prevalence, mortality, psychological trauma, screening tool, clinical interview
MeSH terms
Humans, Stress Disorders, Post-Traumatic, Prevalence, Acute Coronary Syndrome

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