Abstract 17340: Posttraumatic Stress Disorder is Associated With Impaired Coronary Distensibility and Extent of Coronary Atherosclerosis
Background: Impaired coronary distensibility index (CDI) is an endothelial dependent process and is associated with vulnerable plaque composition and cardiovascular mortality. But the impact of post-traumatic stress disorder (PTSD) on CDI has not been evaluated. This study investigated the relation of impaired CDI and extent of coronary atherosclerosis with PTSD.
Methods: One hundred and six subjects (aged 63±10 years, 31% women) with (n=24) and without (n=82) PTSD underwent computed tomography angiography (CTA) and their CDI and extent of coronary atherosclerosis were assessed. CDI in left anterior descending artery (LAD) was defined as: [(Early diastole - mid diastole lumen cross section area (CSA))/ (lumen CSA in mid diastole x central pulse pressure) x 1000]. Extent of coronary atherosclerosis was defined as normal, non-obstructive (<50%luminal stenosis) and obstructive (>50%). Conditional logistic regression was employed to assess the relation of CDI, extent of coronary atherosclerosis with PTSD.
Results: CDI was significantly lower in PTSD as compared to no-PTSD subjects (3.4±1.4 vs.4.8±1.5, p=0.01) and was more prominent in women than men (figure). After adjustment for risk factors, the relative risk of each standard deviation decrease in CDI was 43% higher in PTSD as compared to no-PTSD subjects (relative risk: 0.57, 95%CI 0.39-0.81, p=0.002). CDI was inversely associated with severity of CAD and was more prominent in PTSD than no-PTSD subjects (Figure). This association remained significant after adjustment for risk factors.
Conclusion: PTSD is independently associated with impaired CDI and predicts the extent of coronary atherosclerosis. This highlights the need for further studies evaluating the impact of early PTSD intervention on coronary atherosclerosis.
- © 2013 by American Heart Association, Inc.