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Medical News and Perspectives
July 11, 2012

Study: Acute Coronary Events Linked With PTSD

JAMA. 2012;308(2):121. doi:10.1001/jama.2012.7948

One of every 8 patients who have a myocardial infarction or other acute coronary event develops clinical symptoms of posttraumatic stress disorder (PTSD) annually in the United States, according to recent research.

In a meta-analysis, researchers examined data from 24 studies that included 2383 patients with acute coronary events worldwide. The study also showed that developing PTSD doubles the risk of having another acute episode or dying within 1 to 3 years, compared with cardiac patients who didn't develop PTSD. Given that some 1.4 million patients are hospitalized annually with an acute coronary event, the investigators estimated that 12%, or 168 000 patients, will develop PTSD (Edmondson D et al. PLoS ONE. 2012;7[6]:e38915).

PTSD is most commonly perceived as resulting from exposure to such disturbing events as military combat, sexual assault, and man-made or natural disasters. Common symptoms include intrusive thoughts, nightmares, elevated heart rate and blood pressure, and avoiding reminders of the triggering event. “It is also quite common among patients who have had a severe coronary event,” said lead author Donald Edmondson, PhD, of the Columbia University Medical Center in New York, NY, in a statement.

In fact, Edmondson said evidence shows that psychological disorders are underrecognized and undertreated in heart patients. “Underdiagnosis may be even more pronounced in cardiac practices than in other types of medical practices,” he said.

The study noted that the cost to the US health care system of recurrent acute coronary events linked with PTSD could be in the hundreds of millions of dollars. Effective treatment is available for PTSD, but Edmondson said physicians and patients first must become aware of the link with acute coronary events. The next step is research to determine whether treating PTSD symptoms can reduce recurrences of acute heart problems and related mortality.

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