Centre Hospitalier du Pays d'Avesnes, Route de Haut-Lieu, 59363 Avesnes-sur-Helpe, France; Université de Lorraine, Département de psychologie de la santé, APEMAC/EPSAM UE 4360, Ile du Saulcy, 57000 Metz, France.
Université de Lorraine, Département de psychologie de la santé, APEMAC/EPSAM UE 4360, Ile du Saulcy, 57000 Metz, France.
J Affect Disord. 2022 Jan 15;297:525-535. doi: 10.1016/j.jad.2021.10.056. Epub 2021 Oct 26.
Each year, nearly 790.000 new cases of myocardial infarction (MI) are recorded in the United States. Better knowledge of the modifiable risk factors for this cardiovascular disease remains a major public health issue. In this perspective, the aim of this systematic review and meta-analysis was to estimate the relationship between post-traumatic stress disorder (PTSD) and risk of subsequent myocardial infarction (MI).
A systematic review using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines was performed by searching four bibliographic databases (PubMed/Medline, PsycINFO, Science Direct and Proquest Dissertations and Theses).
A total of 14 articles were included. Nine of these included depression as a covariate. Among 13 studies (N = 848.903), the pooled HR for the magnitude of the relationship between PTSD and MI was 1.49 (95% CI 1.31-1.69) before adjustment for depression. The pooled HR estimate for the 9 depression-adjusted estimates (N = 814.441) was 1.32 (95% CI 1.12-1.56).
These results should be considered with caution because there is high heterogeneity between studies and possible publication bias; thus, further research is required to support these results.
Further research is still needed to identify in more precise terms the mediating factors involved in the direct association between PTSD and the subsequent occurrence of ischemic heart disease.
在美国，每年有近 79 万例心肌梗死 (MI) 新发病例。更好地了解这种心血管疾病的可改变危险因素仍然是一个主要的公共卫生问题。在这方面，本系统评价和荟萃分析的目的是估计创伤后应激障碍 (PTSD) 与随后发生心肌梗死 (MI) 的风险之间的关系。
使用 PRISMA（系统评价和荟萃分析的首选报告项目）指南进行系统评价，通过搜索四个文献数据库（PubMed/Medline、PsycINFO、Science Direct 和 Proquest Dissertations and Theses）进行搜索。
共纳入 14 篇文章。其中 9 篇文章将抑郁作为协变量。在包括 13 项研究（N=848903）中，在调整抑郁因素之前， PTSD 与 MI 之间关系的汇总 HR 为 1.49（95%CI 1.31-1.69）。在调整抑郁因素的 9 项估计值（N=814441）中，汇总 HR 估计值为 1.32（95%CI 1.12-1.56）。
由于研究之间存在高度异质性和可能存在发表偏倚，因此应谨慎考虑这些结果；因此，需要进一步的研究来支持这些结果。
仍需要进一步的研究来更准确地确定 PTSD 与随后发生缺血性心脏病之间直接关联所涉及的中介因素。
