Posttraumatic stress syndromes and health-related quality of life following myocardial infarction: 8-year follow-up.

OBJECTIVES

This study examines the implications of acute stress disorder (ASD), following myocardial infraction (MI), in predicting subsequent posttraumatic stress disorder (PTSD) and impaired quality of life (QoL) 8 years post-MI.

METHODS

MI patients, who were assessed within a week of the MI (Time 1; n=173), were followed up 7 months (Time 2; n=116) and 8 years (Time 3; n=90) post-MI. ASD was assessed at Time 1 and PTSD at Time 2 and Time 3. Health-related QoL was assessed at Time 3.

RESULTS

Unconditional latent class growth models revealed two distinct subpopulations: the recovered/resilient group (94%) demonstrated a decrease from 12.4% of ASD at Time 1 to 6.1% of PTSD at Time 3. Rates of posttraumatic stress syndromes in the chronic group (6%) were 85.3% at Time 1 and 75.7% at Time 3. The two groups differed in pre-MI life events, length of hospitalization, likelihood to have anterior MI, and perceived threat of death. The chronic group reported lower levels of QoL at Time 3.

CONCLUSION

Although most ASD patients demonstrate a trend of recovery, ASD in the immediate aftermath of MI remains a marker of long term adjustment difficulties.