Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, 622 West 168(th) Street, New York, NY 10032, USA.
Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Irving Medical Center, 622 West 168(th) Street, New York, NY 10032, USA.
Gen Hosp Psychiatry. 2024 Jan-Feb;86:103-107. doi: 10.1016/j.genhosppsych.2023.11.014. Epub 2023 Dec 30.
Posttraumatic stress symptoms (PSS) due to acute cardiac events are common and may lead patients to avoid secondary prevention behaviors. However, patients' daily experience of cardiac event-induced PSS has not been studied after a potentially traumatic cardiac hospitalization.
In an observational cohort study, 108 mostly male patients with coronary heart disease were recruited after evaluation for suspected acute coronary syndrome (ACS). One month later, PSS were assessed via telephone-administered PTSD Checklist for DSM-5 (PCL-5). The exposure of interest was elevated (PCL-5 ≥ 20) vs. non-elevated PSS (PCL-5 ≤ 5). The occurrence and severity of cardiac-related intrusive thoughts were assessed 5 times daily for 2 weeks via electronic surveys on a wrist-worn device.
Moderate-to-severe intrusive thoughts were experienced by 48.1% of patients but more commonly by elevated-PSS (n = 36; 66.7%) than non-elevated-PSS (n = 72; 38.9%) patients. After adjustment for demographic and clinical characteristics, elevated- vs. non-elevated-PSS patients had a 9-fold higher odds of experiencing a moderate-to-severe intrusive thought during each 2-h assessment interval (adjusted OR = 9.14, 95% CI [2.99, 27.92], p < .01). After adjustment, intrusive thoughts on a 0-to-6 point scale were over two times as intense for elevated-PSS vs. non-elevated-PSS patients.
Intrusive thoughts about cardiac risk were common in patients recently evaluated for ACS, but much more prevalent and intense in those with elevated vs non-elevated PSS.
急性心脏事件导致的创伤后应激症状（PSS）较为常见，可能导致患者避免采取二级预防行为。然而，在经历可能导致创伤的心脏住院治疗后，尚未研究患者对心脏事件引起的 PSS 的日常体验。
在一项观察性队列研究中，对疑似急性冠状动脉综合征（ACS）的 108 例冠心病患者进行评估后招募了这些患者。一个月后，通过电话进行 PTSD 检查表 DSM-5（PCL-5）评估 PSS。感兴趣的暴露是升高的（PCL-5≥20）与非升高的 PSS（PCL-5≤5）。通过佩戴在手腕上的设备上进行的电子调查，在 2 周内每天 5 次评估心脏相关的侵入性思维的发生和严重程度。
48.1%的患者经历了中度至重度的侵入性思维，但升高的 PSS（n=36；66.7%）患者比非升高的 PSS（n=72；38.9%）患者更常见。在调整人口统计学和临床特征后，与非升高 PSS 患者相比，升高 PSS 患者在每次 2 小时评估间隔内经历中度至重度侵入性思维的可能性高 9 倍（调整后的 OR=9.14，95%CI[2.99，27.92]，p<0.01）。调整后，升高 PSS 患者的侵入性思维在 0 到 6 分的量表上的强度是升高 PSS 患者的两倍以上。
在最近接受 ACS 评估的患者中，对心脏风险的侵入性思维很常见，但在升高的 PSS 患者中更为常见且强度更高。
