Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review.
Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review.
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DOI：
10.1371/journal.pone.0038915
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Neria Y
中科院分区：
文献类型：
--
作者：
Edmondson D;Richardson S;Falzon L;Davidson KW;Mills MA;Neria Y
急性冠状动脉综合征（ACS;急性心肌梗死或不稳定型心绞痛）可诱发创伤后应激障碍（PTSD），ACS诱发的PTSD可增加患者随后心脏事件和死亡率的风险。目的：通过系统回顾和荟萃分析，确定ACS诱导的PTSD的患病率，并量化ACS诱导的PTSD与不良临床结局之间的相关性。数据来源：通过检索奥维德MEDLINE、PsycINFO和Scopus以及通过手动检索参考文献列表识别文章。评估PTSD的观察性队列研究，具体参考至少1个月前的ACS事件。我们提取了ACS诱导的PTSD患病率的估计值，以及与临床结局的相关性和研究特征。我们确定了56篇潜在相关文章，其中24篇符合我们的标准（N = 2383）。 在随机效应模型中，荟萃分析得出ACS诱导的PTSD临床显著症状的总体患病率估计值为12%（95%置信区间[CI]，9%-16%）。个体研究患病率估计值差异很大（0%-32%），使用筛选工具（16项研究的患病率估计值为16% [95% CI，13%-20%]）与临床诊断访谈（8项研究的患病率估计值为4% [95% CI，3%-5%]）解释了估计值的显著异质性。在符合我们标准的3项研究（N = 609）中，ACS诱导的PTSD与临床结局（即死亡率和/或ACS复发）之间关系的聚集点估计值表明，相对于无PTSD症状的患者，有临床显著PTSD症状的ACS患者的风险加倍（风险比，2.00; 95% CI，1.69-2.37）。 这项荟萃分析表明，ACS引起的临床显著的PTSD症状是中度流行的，并与心脏事件复发和死亡率增加的风险有关。ACS诱导的PTSD和临床结果之间的关系还需要进一步的测试。
Acute coronary syndromes (ACS; myocardial infarction or unstable angina) can induce posttraumatic stress disorder (PTSD), and ACS-induced PTSD may increase patients’ risk for subsequent cardiac events and mortality. Objective: To determine the prevalence of PTSD induced by ACS and to quantify the association between ACS-induced PTSD and adverse clinical outcomes using systematic review and meta-analysis. Data Sources: Articles were identified by searching Ovid MEDLINE, PsycINFO, and Scopus, and through manual search of reference lists. Observational cohort studies that assessed PTSD with specific reference to an ACS event at least 1 month prior. We extracted estimates of the prevalence of ACS-induced PTSD and associations with clinical outcomes, as well as study characteristics. We identified 56 potentially relevant articles, 24 of which met our criteria (N = 2383). Meta-analysis yielded an aggregated prevalence estimate of 12% (95% confidence interval [CI], 9%–16%) for clinically significant symptoms of ACS-induced PTSD in a random effects model. Individual study prevalence estimates varied widely (0%–32%), with significant heterogeneity in estimates explained by the use of a screening instrument (prevalence estimate was 16% [95% CI, 13%–20%] in 16 studies) vs a clinical diagnostic interview (prevalence estimate was 4% [95% CI, 3%–5%] in 8 studies). The aggregated point estimate for the magnitude of the relationship between ACS-induced PTSD and clinical outcomes (ie, mortality and/or ACS recurrence) across the 3 studies that met our criteria (N = 609) suggested a doubling of risk (risk ratio, 2.00; 95% CI, 1.69–2.37) in ACS patients with clinically significant PTSD symptoms relative to patients without PTSD symptoms. This meta-analysis suggests that clinically significant PTSD symptoms induced by ACS are moderately prevalent and are associated with increased risk for recurrent cardiac events and mortality. Further tests of the association of ACS-induced PTSD and clinical outcomes are needed.
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影响因子：
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作者：
Glassman, Alexander H.;Bigger, J. Thomas, Jr.;Gaffney, Michael
通讯作者：
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DOI：
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发表时间：
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