The occurrence of ST elevation myocardial infarction (STEMI) and non-STEMI in patients with post traumatic stress disorder (PTSD) using the large nationwide inpatient sample (NIS).

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American journal of cardiovascular disease Pub Date : 2024-06-15 eCollection Date: 2024-01-01 DOI:10.62347/YTCI7645

Abdullah Mohamed Niyas, Fathima Haseefa, Mohammad Reza Movahed, Mehrtash Hashemzadeh, Mehrnoosh Hashemzadeh

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Abstract

Background: 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.

Method: 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.

Results: 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).

Conclusion: 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.

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利用大型全国住院病人样本（NIS），研究创伤后应激障碍（PTSD）患者ST段抬高型心肌梗死（STEMI）和非STEMI的发生率。

背景：创伤后应激障碍会导致应激激素水平升高和自主神经系统调节失调，从而引发心脏事件。本研究的目的是利用大型数据库评估创伤后应激障碍与 STEMI 和 NSTEMI 发生之间的关联：我们使用全国住院患者样本（NIS）和 2005 年至 2014 年的 ICD-9 编码（n=1,621,382），对患有和未患有创伤后应激障碍的 40 岁以上患者在院内发生 STEMI 和 NSTEMI 的情况进行了单变量卡方分析。我们还对年龄、性别、糖尿病、种族、高脂血症、高血压和吸烟等基线特征进行了多变量分析：2005-2014年的数据集中包含401,485名STEMI患者（其中745人或0.19%患有创伤后应激障碍）和1,219,897名NSTEMI患者（其中2,441人或0.15%患有创伤后应激障碍）。在 2005 年的数据集中，0.5% 的创伤后应激障碍患者患有 STEMI，而非创伤后应激障碍患者的这一比例为 1.0%（OR=0.46，95% C.I.，0.36-0.59）。同样，0.6%的创伤后应激障碍患者和2.2%的非创伤后应激障碍患者患有NSTEMI（OR=0.28，95% C.I.，0.23-0.35）。在2014年的数据集中，0.3%的创伤后应激障碍患者患有STEMI，而非创伤后应激障碍患者的这一比例为0.7%（OR=0.43，95% C.I.，0.35-0.51）。同样，1.4%的创伤后应激障碍患者与2.9%的非创伤后应激障碍患者相比患有NSTEMI（OR=0.48，95% C.I.，0.44-0.52）。在整个十年期间也出现了类似的趋势。调整年龄、性别、糖尿病、种族、高脂血症、高血压和吸烟等因素后，创伤后应激障碍与STEMI（2005年：OR=0.50，95% C.I.，0.37-0.66；2014年：OR=0.35，95% C.I.，0.29-0.43）和NSTEMI（2005年：OR=0.44，95% C.I.，0.34-0.57；2014年：OR=0.63，95% C.I.，0.58-0.69）发生率较低有关：通过使用大型住院患者数据库，我们没有发现被诊断患有创伤后应激障碍的患者发生 STEMI 或 NSTEMI 的几率增加，这表明创伤后应激障碍不是心肌梗死的独立危险因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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American journal of cardiovascular disease CARDIAC & CARDIOVASCULAR SYSTEMS-

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