• Humans
• Thrombophilia/epidemiology
• Thrombophilia/etiology
• Thrombophilia/blood
• Stress, Psychological/complications
• Stress, Psychological/blood

• Cognitive-behavioural therapy
• Eye movement desensitization reprocessing
• Myocardial infarction
• Post-traumatic stress disorder
• Psychological intervention
• Systematic review

• Humans
• Stress Disorders, Post-Traumatic/therapy
• Stress Disorders, Post-Traumatic/etiology
• Stress Disorders, Post-Traumatic/psychology
• Myocardial Infarction/psychology
• Myocardial Infarction/complications
• Psychosocial Intervention/methods
• Cognitive Behavioral Therapy
• Depression/therapy
• Anxiety/therapy

• MOH-000364 National Medical Research Council Health Services Research
• Ministry of Health Singapore

• Acute coronary syndrome
• Cardiovascular disease
• Intrusive thoughts
• Posttraumatic stress

• Humans
• Male
• Female
• Stress Disorders, Post-Traumatic/epidemiology
• Stress Disorders, Post-Traumatic/diagnosis
• Ecological Momentary Assessment
• Cognition
• Acute Coronary Syndrome/epidemiology
• Acute Coronary Syndrome/complications
• Cohort Studies

• R01 HL128497 NHLBI NIH HHS
• R01 HL151850 NHLBI NIH HHS
• R01 HL128310 NHLBI NIH HHS
• R01 HL117832 NHLBI NIH HHS
• R01 HL123368 NHLBI NIH HHS
• R01 HL153311 NHLBI NIH HHS

• Comorbid mental health
• Mental health
• Mental trauma
• Myocardial infarction
• Post-traumatic stress disorder (PTSD)
• Public health
• Stressful life events
• The Tromsø Study

• Male
• Humans
• Female
• Stress Disorders, Post-Traumatic/diagnosis
• Stress Disorders, Post-Traumatic/epidemiology
• Stress Disorders, Post-Traumatic/etiology
• Cross-Sectional Studies
• Follow-Up Studies
• Myocardial Infarction/complications
• Myocardial Infarction/diagnosis
• Myocardial Infarction/epidemiology
• Anxiety Disorders/complications

• UiT The Arctic University of Norway (incl University Hospital of North Norway)

Studies have demonstrated that patients who have experienced acute coronary syndrome (ACS) have an increased risk of developing posttraumatic stress disorder (PTSD) and experiencing worse survival outcomes than those who do not develop PTSD. Nevertheless, the prevalence rates of PTSD following ACS vary widely across studies, and it is noteworthy that in most cases, the diagnosis of PTSD was based on self-report symptom questionnaires, rather than being established by psychiatrists. Additionally, the individual characteristics of patients who develop PTSD after ACS can differ widely, making it difficult to identify any consistent patterns or predictors of the disorder.

To investigate the prevalence of PTSD among a large sample of patients undergoing cardiac rehabilitation (CR) after ACS, as well as their characteristics in comparison to a control group.

The participants of this study are patients who have experienced ACS with or without undergoing percutaneous coronary intervention and are enrolled in a 3-wk CR program at the largest CR center in Croatia, the Special Hospital for Medical Rehabilitation Krapinske Toplice. Patient recruitment for the study took place over the course of one year, from January 1, 2022, to December 31, 2022, with a total of 504 participants. The expected average follow-up period for patients included in the study is about 18 mo, and currently ongoing. Using self-assessment questionnaire for PTSD criteria and clinical psychiatric interview, a group of patients with a PTSD diagnosis was identified. From the participants who do not have a PTSD diagnosis, patients who would match those with a PTSD diagnosis in terms of relevant clinical and medical stratification variables and during the same rehabilitation period were selected to enable comparability of the two groups.

A total of 507 patients who were enrolled in the CR program were approached to participate in the study. Three patients declined to participate in the study. The screening PTSD Checklist-Civilian Version questionnaire was completed by 504 patients. Out of the total sample of 504 patients, 74.2% were men (n = 374) and 25.8% were women (n = 130). The mean age of all participants was 56.7 years (55.8 for men and 59.1 for women). Among the 504 participants who completed the screening questionnaire, 80 met the cutoff criteria for the PTSD and qualified for further evaluation (15.9%). All 80 patients agreed to a psychiatric interview. Among them, 51 patients (10.1%) were diagnosed with clinical PTSD by a psychiatrist according to Diagnostic and Statistical Manual of Mental Disorders criteria. Among the variables analyzed, there was a noticeable difference in the percentage of theoretical maximum achieved on exercise testing between the PTSD and non-PTSD groups. Non-PTSD group achieved a significantly higher percentage of their maximum compared to the PTSD group (P = 0.035).

The preliminary results of the study indicate that a significant proportion of patients with PTSD induced by ACS are not receiving adequate treatment. Furthermore, the data suggest that these patients may exhibit reduced physical activity levels, which could be one of the possible underlying mechanisms in observed poor cardiovascular outcomes in this population. Identifying cardiac biomarkers is crucial for identifying patients at risk of developing PTSD and may derive benefits from personalized interventions based on the principles of precision medicine in multidisciplinary CR programs.

• Cardiac rehabilitation
• Acute coronary syndrome
• Posttraumatic stress disorder
• Psychiatric interview
• Multidisciplinary team
• Cardiac biomarkers

• Acute coronary syndrome (ACS)
• Cardiac-induced posttraumatic stress disorder (CDI-PTSD)
• Cardiovascular disease (CVD)
• Posttraumatic stress disorder (PTSD)
• Posttraumatic stress symptoms (PTSS)

• Gender
• NESARC–III
• National epidemiologic survey on Alcohol and related Conditions–III
• PTSD

• acute coronary care
• acute trauma stress
• behavioral cardiology
• counseling
• early prevention
• myocardial infarction
• posttraumatic stress symptoms

• Anxiety
• Coping strategies
• Depression
• HRQoL
• Myocardial infarction
• PTSD
• Stroke
• TIA

• Aged
• Female
• Humans
• Ischemic Attack, Transient/complications
• Ischemic Attack, Transient/epidemiology
• Male
• Myocardial Infarction/epidemiology
• Prevalence
• Quality of Life
• Stress Disorders, Post-Traumatic/epidemiology
• Stroke/complications
• Stroke/epidemiology

• Private Universität Witten/Herdecke gGmbH (3128)

• Epidemiology
• Medical Trauma
• Post-Traumatic
• Prevalence
• Psychosomatic Medicine
• Stress Disorders

• Causality
• Humans
• Myocardial Infarction/psychology
• Prevalence
• Risk Factors
• Stress Disorders, Post-Traumatic/epidemiology
• Stress Disorders, Post-Traumatic/psychology

• acute coronary syndrome
• emergency psychiatry
• post-traumatic stress
• prevention
• psychological stress
• risk factor
• trauma stress

As many as 1 in 8 acute coronary syndrome (ACS) patients develop posttraumatic stress disorder (PTSD) due to the ACS, and ACS-induced PTSD may increase secondary cardiovascular disease (CVD) risk. However, prior studies have been small and underpowered to test plausible behavioral or biological mechanisms of the hypothesized PTSD-secondary CVD risk association. In this paper, we describe the design and methods of a large prospective observational cohort study to estimate the prognostic significance of ACS-induced PTSD, mechanisms for its association with CVD risk, and emergency department (ED) factors that may increase PTSD risk, in a cohort of patients evaluated for acute coronary syndrome (ACS) in the ED of a large, urban academic medical center.

The Reactions to Acute Care and Hospitalization (ReACH) study follows 1,741 racially, ethnically, and socioeconomically diverse patients initially presenting to the ED with ACS symptoms. Psychosocial factors are assessed at baseline. Medication adherence is monitored by electronic pill bottle (eCAP). Participants are contacted by phone at 1-, 6-, and 12-months post-hospitalization to assess PTSD symptoms, hospital readmission, and recurrent CVD events/mortality (proactively searched and confirmed by medical records).

This study will provide the most accurate estimates to date of PTSD’s association with recurrent CVD events and mortality and will test whether medication adherence mediates that association. Further, it will provide estimates of the contribution of ED and hospital factors to PTSD risk in ACS patients. If our hypotheses are supported, we will have identified PTSD as a novel target for secondary risk reduction.

• acute coronary syndrome
• cardiovascular disease
• emergency department
• medication adherence
• posttraumatic stress disorder
• psychosocial factors

Post traumatic stress disorder is a psychiatric disease that is usually precipitated by life threatening stressors. Myocardial infarction, especially in the young can count as one such event. The development of post traumatic stress after a coronary event not only adversely effects psychiatric health, but leads to increased cardiovascular morbidity and mortality. There is increasing evidence that like major depression, post traumatic stress disorder is also a strong coronary risk factor. Early diagnosis and treatment of this disease in patients with acute manifestations of coronary artery disease can improve patient outcomes.

• Postcoronary artery bypass graft surgery posttraumatic stress disorder
• postmyocardial infarction and posttraumatic stress disorder
• posttraumatic stress disorder

The aim of this study was to examine whether heart drawings of patients with acute myocardial infarction reflect acute distress symptoms and negative illness beliefs and predict posttraumatic stress symptoms 3 months post-myocardial infarction. In total, 84 patients aged over 18 years drew pictures of their heart. The larger the area drawn as damaged, the greater were the levels of acute distress (r = 0.36; p < 0.05), negative illness perceptions (r = 0.42, p < 0.05), and posttraumatic stress symptoms (r = 0.54, p < 0.01). Pain drawings may offer a tool to identify maladaptive cognitions and thus patients at risk of posttraumatic stress disorder.

• drawings
• illness perceptions
• myocardial infarction
• psychological stress
• traumatic stress