Niyas Abdullah Mohamed, Haseefa Fathima, Movahed Mohammad Reza, Hashemzadeh Mehrtash, Hashemzadeh Mehrnoosh
University of Arizona College of Medicine Phoenix, AZ, USA.
University of Arizona College of Medicine Tucson, AZ, USA.
Am J Cardiovasc Dis. 2024 Jun 15;14(3):172-179. doi: 10.62347/YTCI7645. eCollection 2024.
PTSD leads to increased levels of stress hormones and dysregulation of the autonomic nervous system which may trigger cardiac events. The goal of this study is to evaluate any association between PTSD and the occurrence of STEMI and NSTEMI using a large database.
Using the Nationwide Inpatient Sample (NIS) and ICD-9 codes from 2005 to 2014 (n=1,621,382), we performed a univariate chi-square analysis of in-hospital occurrence of STEMI and NSTEMI in patients greater than 40 years of age with and without PTSD. We also performed a multivariate analysis adjusting for baseline characteristics including age, gender, diabetes, race, hyperlipidemia, hypertension, and tobacco use.
The 2005-2014 dataset contained 401,485 STEMI patients (745, or 0.19%, with PTSD) and 1,219,897 NSTEMI patients (2,441, or 0.15%, with PTSD). In the 2005 dataset, 0.5% of PTSD patients had STEMI compared to 1.0% of non-PTSD patients (OR=0.46, 95% C.I., 0.36-0.59). Similarly, 0.6% of patients with PTSD and 2.2% of patients without PTSD had NSTEMI (OR=0.28, 95% C.I., 0.23-0.35). In the 2014 dataset, 0.3% of PTSD patients had STEMI compared to 0.7% of non-PTSD patients (OR=0.43, 95% C.I., 0.35-0.51). Similarly, 1.4% of patients with PTSD versus 2.9% of patients without PTSD had NSTEMI (OR=0.48, 95% C.I., 0.44-0.52). Similar trends were seen throughout the ten-year period. After adjusting for age, gender, diabetes, race, hyperlipidemia, hypertension, and tobacco use, PTSD was associated with a lower occurrence of STEMI (2005: OR=0.50, 95% C.I., 0.37-0.66; 2014: OR=0.35, 95% C.I., 0.29-0.43) and NSTEMI (2005: OR=0.44, 95% C.I., 0.34-0.57; 2014: OR=0.63, 95% C.I., 0.58-0.69).
Using a large inpatient database, we did not find an increased occurrence of STEMI or NSTEMI in patients diagnosed with PTSD, suggesting that PTSD is not an independent risk factor for myocardial infarction.
创伤后应激障碍（PTSD）会导致应激激素水平升高以及自主神经系统失调，这可能引发心脏事件。本研究的目的是使用一个大型数据库评估PTSD与ST段抬高型心肌梗死（STEMI）和非ST段抬高型心肌梗死（NSTEMI）发生之间的任何关联。
利用2005年至2014年的全国住院患者样本（NIS）和国际疾病分类第九版（ICD - 9）编码（n = 1,621,382），我们对年龄大于40岁且患有和未患有PTSD的患者住院期间发生STEMI和NSTEMI的情况进行了单因素卡方分析。我们还进行了多因素分析，对包括年龄、性别、糖尿病、种族、高脂血症、高血压和吸烟在内的基线特征进行了调整。
2005 - 2014年数据集包含401,485例STEMI患者（745例，即0.19%，患有PTSD）和1,219,897例NSTEMI患者（2,441例，即0.15%，患有PTSD）。在2005年的数据集中，0.5%的PTSD患者发生了STEMI，而非PTSD患者为1.0%（比值比[OR]=0.46，95%置信区间[C.I.]，0.36 - 0.59）。同样，0.6%的PTSD患者和2.2%的非PTSD患者发生了NSTEMI（OR = 0.28，95% C.I.，0.23 - 0.35）。在2014年的数据集中，0.3%的PTSD患者发生了STEMI，而非PTSD患者为0.7%（OR = 0.43，95% C.I.，0.35 - 0.51）。同样，1.4%的PTSD患者和2.9%的非PTSD患者发生了NSTEMI（OR = 0.48，95% C.I.，0.44 - 0.52）。在整个十年期间都观察到了类似的趋势。在对年龄、性别、糖尿病、种族、高脂血症、高血压和吸烟进行调整后，PTSD与STEMI发生率较低相关（2005年：OR = 0.50，95% C.I.，0.37 - 0.66；2014年：OR = 0.35，95% C.I.，0.29 - 0.43）以及与NSTEMI发生率较低相关（2005年：OR = 0.44，95% C.I.，0.34 - 0.57；2014年：OR = 0.63，95% C.I.，0.58 - 0.69）。
使用一个大型住院患者数据库，我们未发现被诊断患有PTSD的患者中STEMI或NSTEMI发生率增加，这表明PTSD不是心肌梗死的独立危险因素。
