Abstract 14510: Post-traumatic Stress Disorder and Traumatic Brian Injury Are Associated With Increased Incidence of Myocardial Infarction in US Veterans

Autor:	Olurinde Oni, Rishi Sharma, Hemant Thakur, Garima Thakkar, Vikas Singh, Laith Derbas, Mukut Sharma, Ram Sharan Sharma
Rok vydání:	2020
Předmět:	medicine.medical_specialty nervous system business.industry Physiology (medical) Incidence (epidemiology) Emergency medicine Traumatic stress medicine Myocardial infarction Cardiology and Cardiovascular Medicine medicine.disease business behavioral disciplines and activities
Zdroj:	Circulation. 142
ISSN:	1524-4539 0009-7322
Popis:	Background: We have recently shown that PTSD/TBI takes an especially devastating toll on America’s veterans and their families with mental, physical and financial ramifications and poor clinical outcomes (Thakur et al. Epidemiology (Sunnyvale) 2018; 8:353). Patients with PTSD were found to have higher rates of cardiovascular symptoms, hospitalizations and mortality. Whereas electrocardiographic abnormalities, arrhythmias and ventricular dysfunction have been reported in patients with TBI. Association of PTSD/TBI with Myocardial Infarction (MI) is not well studied; the objective of this study was to examine the relationship between PTSD/TBI and MI in a large patient population. Methods: This retrospective study used national data from Veterans Administrations Informatics and Computing Infrastructure (VINCI). Propensity score analysis was performed to obtain matched pairs of (1) Non-PTSD/TBI vs. PTSD (2) Non-PTSD/TBI vs. TBI. Confounding variables used for matching were patients’ demographics and co-morbidities. Cox proportional hazard regression analysis was conducted on matched pairs to determine the relationship between PTSD, TBI and incidence of MI. Kaplan-Meier curves were plotted to compare the time to development of incident MI among the groups. Relationships between variables were examined using chi-square tests, t-tests and non-parametric tests. Results: The risk of new-onset MI was significantly higher for patients with PTSD/TBI when compared with their counterparts without PTSD/TBI. Risk of MI with TBI (HR=2.687, CI 2.546-2.835, P Conclusion: There is a significant increase in the incidence of MI in patients with a diagnosis of PTSD or TBI. Further studies are needed to formulate clinical guidelines to risk stratify and intervene to help reduce the incidence of MI in this patient population.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::eda147ab76430c3a07d8d50a5d9d06e2 https://doi.org/10.1161/circ.142.suppl_3.14510 Zobrazit plný text záznamu