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Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review.
Open accessAbstract
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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“The most common disorders among CVD patients are pathological stress reactions after a cardiovascular event, depressive and anxiety disorders (3–6).”
From Metacognitive Short-Term Intervention in Patients With Mental Disorders Following Cardiovascular Events (2022) · cites this paper as [4]
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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
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2012-06-20
- Volume
- 7
- Issue
- 6
- Pages
- e38915
- ISSN
- 1932-6203 (ISSN-L)
- 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
- gold
- doi.org
- 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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