Abstract 13403: Posttraumatic Stress Disorder is Associated With Impaired Coronary Distensibility and Predicts Major Adverse Cardiovascular Events
Introduction: Impaired coronary distensibility index (CDI) is an endothelial dependent process and is associated with vulnerable plaque composition and cardiovascular mortality. We recently reported that PTSD is independently associated with impaired CDI. This study investigates the relation of impaired CDI and PTSD with major adverse cardiovascular events (MACE).
Hypothesis: There is a significant association between PTSD and impaired CDI with MACE.
Methods: This study is consist of 246 subjects (aged 63±10 years, 12% women) with (n=50) and without (n=196) PTSD underwent computed tomography angiography (CTA) and their CDI were assessed. Subjects were followed for the median of 50 months. 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]. Major-adverse-cardiac-event (MACE) was defined as myocardial-infarction or cardiovascular-death. Survival regression was employed to assess the relation of impaired CDI and PTSD with MACE.
Results: CDI was significantly lower in PTSD (3.4±1.4) as compared to no-PTSD subjects (4.8±1.5) (p=0.01). After adjustment for risk factors, the relative risk of MACE was 56% higher in those with PTSD as compared with those without PTSD (P=0.001). Similarly, the relative risk of MACE was 95% higher with unit decrease in CDI (p=0.001). Regression analyses revealed significant linkage between PTSD and impaired CDI with increased risk of MACE. After adjustment for age, gender, conventional risk factors, and CTA diagnosed CAD, the relative risk of MACE was 234% higher in each unit decrease in CDI & presence of PTSD as compared to those without PTSD (p=0.001)(Figure).
Conclusions: PTSD is independently associated with impaired CDI and predicts the major adverse cardiovascular events. Our findings suggest that measures of CDI can identify PTSD individuals at risk for MACE.
Author Disclosures: N. Ahmadi: None. V. Nabavi Larijani: None. F. Hajsadeghi: None. M. Budoff: Speakers Bureau; Modest; GE.
This research has received full or partial funding support from the American Heart Association.
- © 2014 by American Heart Association, Inc.