Table 1.
Patient Characteristics Overall and by SCAD‐Induced PTSD Status
| Characteristic | Total (N=859) | SCAD‐induced PTSD status | P value | Valid n | |||
|---|---|---|---|---|---|---|---|
| No lifetime PTSD symptoms (n=48) | Lifetime PTSD symptoms, no diagnosis (n=513) | Lifetime PTSD diagnosis, no past‐month PTSD diagnosis (n=243) | Past‐month PTSD diagnosis (n=55) | ||||
| Demographics | |||||||
| Age at enrollment, y, mean (SD) | 52.3 (10.5) | 58.1 (12.3) | 53.6 (10.0) | 49.9 (10.2) | 45.8 (9.5) | <0.001* | 774 |
| Sex | 0.001† | 858 | |||||
| Women | 806 (93.9%) | 39 (81.3%) | 483 (94.2%) | 230 (95.0%) | 54 (98.2%) | ||
| Men | 52 (6.1%) | 9 (18.8%) | 30 (5.8%) | 12 (5.0%) | 1 (1.8%) | ||
| Race, n (%) | 0.183† | 827 | |||||
| American Indian/Alaska Native | 3 (0.4%) | 0 (0.0%) | 3 (0.6%) | 0 (0.0%) | 0 (0.0%) | ||
| Asian | 15 (1.8%) | 1 (2.2%) | 11 (2.2%) | 1 (0.4%) | 2 (3.8%) | ||
| Black | 60 (7.3%) | 3 (6.5%) | 35 (7.0%) | 14 (6.1%) | 8 (15.1%) | ||
| Native Hawaiian/Pacific Islander | 1 (0.1%) | 0 (0.0%) | 0 (0.0%) | 1 (0.4%) | 0 (0.0%) | ||
| White | 736 (89.0%) | 42 (91.3%) | 444 (89.3%) | 208 (90.0%) | 42 (79.2%) | ||
| Multiracial | 8 (1.0%) | 0 (0.0%) | 3 (0.6%) | 5 (2.2%) | 0 (0.0%) | ||
| Other | 4 (0.5%) | 0 (0.0%) | 1 (0.2%) | 2 (0.9%) | 1 (1.9%) | ||
| Hispanic or Latino ethnicity, n (%) | 40 (4.7%) | 4 (8.3%) | 19 (3.7%) | 15 (6.2%) | 2 (3.6%) | 0.273† | 859 |
| Marital status, n (%) | 0.019† | 859 | |||||
| Single | 82 (9.5%) | 5 (10.4%) | 36 (7.0%) | 28 (11.5%) | 13 (23.6%) | ||
| Married/domestic partner | 677 (78.8%) | 36 (75.0%) | 420 (81.9%) | 185 (76.1%) | 36 (65.5%) | ||
| Divorced | 76 (8.8%) | 7 (14.6%) | 40 (7.8%) | 23 (9.5%) | 6 (10.9%) | ||
| Widowed | 21 (2.4%) | 0 (0.0%) | 15 (2.9%) | 6 (2.5%) | 0 (0.0%) | ||
| Prefer not to say | 3 (0.3%) | 0 (0.0%) | 2 (0.4%) | 1 (0.4%) | 0 (0.0%) | ||
| Education, n (%) | 0.507† | 859 | |||||
| Some high school | 5 (0.6%) | 1 (2.1%) | 3 (0.6%) | 0 (0.0%) | 1 (1.8%) | ||
| High school graduate | 58 (6.8%) | 4 (8.3%) | 34 (6.6%) | 17 (7.0%) | 3 (5.5%) | ||
| Trade school/apprenticeship | 28 (3.3%) | 0 (0.0%) | 13 (2.5%) | 12 (4.9%) | 3 (5.5%) | ||
| Some college | 125 (14.6%) | 8 (16.7%) | 67 (13.1%) | 39 (16.0%) | 11 (20.0%) | ||
| College graduate | 359 (41.8%) | 21 (43.8%) | 229 (44.6%) | 92 (37.9%) | 17 (30.9%) | ||
| Advanced/professional degree | 281 (32.7%) | 14 (29.2%) | 165 (32.2%) | 82 (33.7%) | 20 (36.4%) | ||
| Not sure or prefer not to say | 3 (0.3%) | 0 (0.0%) | 2 (0.4%) | 1 (0.4%) | 0 (0.0%) | ||
| Current employment status, n (%) | <0.001† | 859 | |||||
| Not employed outside home | 107 (12.5%) | 7 (14.6%) | 59 (11.5%) | 31 (12.8%) | 10 (18.2%) | ||
| Retired | 110 (12.8%) | 9 (18.8%) | 78 (15.2%) | 21 (8.6%) | 2 (3.6%) | ||
| Student | 5 (0.6%) | 0 (0.0%) | 3 (0.6%) | 1 (0.4%) | 1 (1.8%) | ||
| Unemployed | 56 (6.5%) | 2 (4.2%) | 20 (3.9%) | 22 (9.1%) | 12 (21.8%) | ||
| Working part‐time | 118 (13.7%) | 3 (6.3%) | 83 (16.2%) | 25 (10.3%) | 7 (12.7%) | ||
| Working full‐time | 435 (50.6%) | 25 (52.1%) | 258 (50.3%) | 132 (54.3%) | 20 (36.4%) | ||
| Not sure or prefer not to say | 28 (3.3%) | 2 (4.2%) | 12 (2.3%) | 11 (4.5%) | 3 (5.5%) | ||
| SCAD history | |||||||
| Age at first SCAD, y, mean (SD) | 49.7 (10.6) | 55.6 (12.3) | 50.8 (10.0) | 47.3 (10.7) | 44.3 (8.8) | <0.001* | 849 |
| Time between worst SCAD event and registry enrollment, y, median (IQR) | 0.7 (0.2–2.6) | 0.6 (0.1–2.7) | 0.8 (0.2–2.8) | 0.7 (0.2–2.3) | 0.3 (0.2–1.3) | 0.229* | 845 |
| History of pregnancy‐related SCAD for those with at least 1 pregnancy, n (%) | 82/645 (12.7%) | 2/33 (6.1%) | 40/389 (10.3%) | 31/178 (17.4%) | 9/45 (20.0%) | 0.028† | 645 |
| Acute emotional stress/anxiety before SCAD, n (%)‡ | 110 (12.8%) | 3 (6.3%) | 61 (11.9%) | 33 (13.6%) | 13 (23.6%) | 0.043† | 859 |
| Cardiac arrest presentation, n (%)§ | 39 (4.5%) | 0 (0.0%) | 19 (3.7%) | 13 (5.3%) | 7 (12.7%) | 0.007† | 859 |
| Cardiogenic shock presentation, n (%)§ | 3 (0.3%) | 0 (0.0%) | 1 (0.2%) | 2 (0.8%) | 0 (0.0%) | 0.517† | 859 |
| NSTEMI presentation, n (%)§ | 416 (48.4%) | 24 (50.0%) | 251 (48.9%) | 117 (48.1%) | 24 (43.6%) | 0.894† | 859 |
| STEMI presentation, n (%)§ | 218 (25.4%) | 14 (29.2%) | 121 (23.6%) | 65 (26.7%) | 18 (32.7%) | 0.385† | 859 |
| Other presentation, n (%)§ , || | 318 (37.0%) | 22 (45.8%) | 188 (36.6%) | 87 (35.8%) | 21 (38.2%) | 0.611† | 859 |
| CABG performed, n (%)§ | 28 (3.7%) | 0 (0.0%) | 15 (3.3%) | 12 (5.5%) | 1 (2.0%) | 0.231† | 765 |
| PCI performed, n (%)§ | 184 (24.1%) | 10 (21.7%) | 100 (22.4%) | 56 (25.6%) | 18 (35.3%) | 0.202† | 763 |
| Medical therapy only, n (%)§ | 560 (73.6%) | 36 (78.3%) | 337 (75.7%) | 155 (70.8%) | 32 (62.7%) | 0.136† | 761 |
| Prior mental health | |||||||
| History of depression, n (%)‡ | 197 (22.9%) | 8 (16.7%) | 97 (18.9%) | 70 (28.8%) | 22 (40.0%) | <0.001† | 859 |
| History of anxiety, n (%)‡ | 267 (31.1%) | 5 (10.4%) | 138 (26.9%) | 97 (39.9%) | 27 (49.1%) | <0.001† | 859 |
| Trauma‐related information | |||||||
| Lifetime cumulative trauma burden, mean (SD) | 1.5 (1.6) | 1.1 (1.3) | 1.3 (1.4) | 1.8 (1.7) | 2.2 (2.0) | <0.001* | 859 |
| Experienced accident/disaster, n (%) | 251 (29.2%) | 10 (20.8%) | 141 (27.5%) | 82 (33.7%) | 18 (32.7%) | 0.164† | 859 |
| Experienced interpersonal or sexual violence, n (%) | 299 (34.8%) | 13 (27.1%) | 154 (30.0%) | 105 (43.2%) | 27 (49.1%) | <0.001† | 859 |
| Experienced combat, n (%) | 12 (1.4%) | 1 (2.1%) | 3 (0.6%) | 7 (2.9%) | 1 (1.8%) | 0.087† | 859 |
| Experienced illness/injury, n (%) | 239 (27.8%) | 10 (20.8%) | 135 (26.3%) | 76 (31.3%) | 18 (32.7%) | 0.278† | 859 |
| Experienced violent death of close other, n (%) | 143 (16.6%) | 8 (16.7%) | 81 (15.8%) | 40 (16.5%) | 14 (25.5%) | 0.340† | 859 |
| Witnessed traumatic event, n (%) | 130 (15.1%) | 5 (10.4%) | 63 (12.3%) | 45 (18.5%) | 17 (30.9%) | <0.001† | 859 |
| No. of lifetime SCAD‐induced PTSD symptoms ever experienced, mean (SD) | 7.8 (5.1) | 0.0 (0.0) | 5.5 (3.2) | 12.4 (3.1) | 16.3 (2.0) | <0.001* | 859 |
| Past‐month SCAD‐induced PTSD symptom severity, mean (SD) | 10.5 (11.2) | 0.0 (0.0) | 6.0 (6.0) | 15.9 (8.6) | 37.9 (10.9) | <0.001* | 859 |
| Health behaviors | |||||||
| Past‐week sleep disturbance by PROMIS T score, mean (SD) | 51.2 (9.4) | 44.1 (8.8) | 49.4 (8.6) | 54.6 (9.1) | 59.9 (8.7) | <0.001* | 854 |
| Current smoker, n (%) | 20 (2.3%) | 1 (2.1%) | 6 (1.2%) | 8 (3.3%) | 5 (9.1%) | 0.002† | 859 |
| Alcohol consumption, n (%) | 0.055† | 850 | |||||
| Never drinker | 199 (23.4%) | 17 (36.2%) | 122 (24.1%) | 48 (19.9%) | 12 (21.8%) | ||
| <1 drink per wk | 375 (44.1%) | 11 (23.4%) | 215 (42.4%) | 118 (49.0%) | 31 (56.4%) | ||
| 1–7 drinks per wk | 220 (25.9%) | 13 (27.7%) | 134 (26.4%) | 62 (25.7%) | 11 (20.0%) | ||
| >7 drinks per wk | 45 (5.3%) | 4 (8.5%) | 30 (5.9%) | 10 (4.1%) | 1 (1.8%) | ||
| Prefer not to say | 11 (1.3%) | 2 (4.3%) | 6 (1.2%) | 3 (1.2%) | 0 (0.0%) | ||
| Disease‐specific health status | |||||||
| Past‐month health status total score, mean (SD) | 73.1 (16.9) | 83.4 (11.3) | 76.0 (15.6) | 68.4 (17.3) | 58.5 (17.0) | <0.001* | 858 |
CABG indicates coronary artery bypass graft; IQR, interquartile range; NSTEMI, non–ST‐segment–elevation myocardial infarction; PCI, percutaneous coronary intervention; PROMIS, Patient‐Reported Outcomes Measurement Information System; PTSD, posttraumatic stress disorder; SCAD, spontaneous coronary artery dissection; and STEMI, ST‐segment–elevation myocardial infarction.
*
Kruskal‐Wallis P value.
†
χ2 P value.
‡
For most recent SCAD event.
§
Investigators could select as many options as applied to the most recent SCAD event; thus, percentages total >100%.
||
Other presentations included asymptomatic, atypical chest pain, stable angina, and unstable angina.