Poster Walk: Cardiology Potpurri

Introduction:Post-traumatic stress disorder (PTSD) may be found in up to 12% of patients experiencing acute coronary syndrome.We sought to find predictors for the occurrence of PTSD after acute ST-elevation myocardial infarction (STEMI) in consecutive patients treated at our institution. Methods:We analysed data from the Fribourg STEMI Fast Track Registry (EVALFAST).Starting in June 2008 all patients admitted to University and Hospital Fribourg via the Fast Track managed care system were prospectively enrolled.Relevant patient and procedural data were prospectively collected.Clinical follow-up was performed by phone or clinic visit.The presence of PTSD was assessed by use of the revised impact of event scale (IES-R) at 1 and 12 months.At 1 month the IES-R was filled out by patients in the presence of a psychotherapist specialized in cardio-psychology.At 12 months the IES-R was mailed to patients for repeated assessment.The PTSD cut-off was set at ≥33 points.Patients with a final diagnosis other than STEMI were excluded from the registry.The primary outcome was the occurrence of PTSD at 12 months.Patients with PTSD were compared to patients without PTSD.Univariate analysis identified variables associated with the occurrence of PTSD at an alpha < 0.25.All identified variables were entered in a logistic regression model. Results:Completed IES-R forms were available in 144 patients.The primary outcome occurred in 20 patients (14%).Overall mean age was 63±11 years and 108 patients (75%) patients were men.The mean total ischemic time was 180min overall and 162min vs. 189min in PTSD and non-PTSD patients, respectively.PTSD patients were younger than their non-PTSD counterparts (56±10 vs. 64±11 years, p=0.01) and more likely to be divorced (30% vs 12%, p=0.03).Four independent predictors for PTSD were identified by binary logistic regression analysis: being employed (OR: 4.25, 95% CI: 1.42-12.7;p=0.01), history of anxiety disorder or depression (OR: 4.44, 95% CI: 1.43-13.8;p=0.01), cardiogenic shock on admission (OR: 6.5, 95% CI: 1.1-38.7;p=0.03) and overweight defined as a BMI of >25 (OR:0.3,95% CI: 0.1-0.9;p=0.04). Conclusion:PTSD following STEMI is common.Patients with known depressive or anxiety disorders and those presenting with cardiogenic shock seem to be particularly at risk for developing PTSD after STEMI. P27