Posttraumatic Stress Disorder Prevalence and Risk of Recurrence in Acute Coronary Syndrome Patients: A Meta-analytic ReviewReportar como inadecuado

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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.


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.

Autor: Donald Edmondson , Safiya Richardson, Louise Falzon, Karina W. Davidson, Mary Alice Mills, Yuval Neria



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