Table 1.
Characteristics of Studies That Estimated an Association Between ACS-Induced PTSD and Adverse Clinical Outcome
| Source, y | N | HR Not Adjusted for Depression | HR Adjusted for Depression; Depression Assessment | Clinical Outcome | Mean Age at Baseline | Mean Follow-up, y | Sample | PTSD Assessment | Covariates Included |
|---|---|---|---|---|---|---|---|---|---|
| Boscarino et al., 200820 | 4,328 | 2.25 (1.02–4.95) | 2.06 (0.92–4.62); Medical record | Heart disease mortality | 36.3 | 15 | US Vietnam era veterans | Self-report based on DSM-III criteria | War theater status, age, intelligence, smoking, BMI, depression history |
| Jordan et al., 201118 | 39,324 | 1.64 (1.42–1.91) | NA | Self-reported physician-diagnosed heart disease | 43.9 | 2.9 | World Trade Center survivors | PCL > 44 | Age, race/ethnicity, education, marital status, smoking, hypertension, diabetes |
| Kubzansky et al, 200722 | 1,002 | 1.42 (1.03–1.95) | 1.30 (0.92–1.80); CES-D | Nonfatal MI and CHD mortality | 63 | 15 | US Vietnam era veterans | Mississippi Scale for Combat-Related PTSD (mean + 2 SD) | Age, smoking, systolic and diastolic blood pressure, total cholesterol, BMI, family history of CHD, education, alcohol |
| Kubzansky et al, 200923 | 1,059 | 3.28 (1.17–8.90) | 2.78 (1.10–7.59); DIS | Angina, nonfatal MI, CHD mortality, other cardiac death | 44.4 | 13 | Baltimore, Maryland women | Diagnostic Interview Schedule for DSM-III | Age, race/ethnicity, smoking, history of high blood pressure, history of diabetes, alcohol use, education, income |
| Scherrer et al, 201019 | 355,999 | 1.39 (1.33–1.46); Age-adjusted only | 1.16 (1.00–1.35); ICD-9 | Incident MI (ICD-9-CM codes 410–411) | 55.7 | 7 | US military veterans | 2 outpatient or 1 inpatient PTSD diagnosis codes (ICD-9-CM: 309.81) | Age, sex, race, marital status, insurance, diabetes, hypertension, hyperlipidemia, obesity, alcohol, nicotine |
| Vaccarino et al., 201321 | 562 | 2.20 (1.2–4.2) | 2.19 (1.1–4.1) | Self-reported hospital admission for heart disease | 42.6 | 13 | Vietnam era veterans (twin study) | Diagnostic Interview Schedule for DSM-III | Age, education, family income, alcohol, smoking, physical activity, hypertension |
Abbreviations: ACS, acute coronary syndrome; CES-D, Center for Epidemiological Studies-Depression; DIS, NIMH Diagnostic Interview Schedule; PTSD, posttraumatic stress disorder; DSM-III, Diagnostic and Statistical Manual of Mental Disorders (3rd Edition); PCL:, PTSD Checklist; BMI, body mass index; CHD, coronary heart disease; ICD, International Classification of Diseases