Post-Traumatic Stress Disorder (PTSD) Symptoms Predict Delay to Hospital in Patients with Acute Coronary Syndrome
Year: 2011
Type: article
Abstract: BACKGROUND: Increased delay to hospital presentation with acute coronary syndrome (ACS) is associated with poor outcomes. While demographic factors associated with this delay have been well described, scarce data are available on the role of modifiable factors, such as psychosocial disorders, on pre-hospital delay. Patients with symptoms of post-traumatic stress disorder (PTSD) often avoid stressful situations and may delay presenting for care when they experience cardiac symptoms. It is unknown, however, whether PTSD symptoms negatively impact the time to presentation during an ACS. METHODS: We assessed the relationship between PTSD symptoms and pre-hospital delay in 241 adults with an ACS in the ongoing Prescription Use, Lifestyle, Stress Evaluation (PULSE) study. RESULTS: Overall, 66% of patients were male; 40% were Hispanic or Latino. The mean age was 61.9±11.6 years old. PTSD symptoms were present in 17.8% of patients. Pre-hospital delay was longer for patients with PTSD symptoms compared to those without [geometric mean: 25.8 hours (95% CI 13.8-44.8) vs. 10.7 hours (95% CI 8.3-13.8)]; P = 0.005. After multivariable adjustment for age, sex, ethnicity, depression, left ventricular ejection fraction and history of myocardial infarction, the mean pre-hospital delay was 173% (95% CI: 36%-450%) longer for patients with versus without PTSD symptoms. CONCLUSION: Among patients presenting with an ACS, PTSD symptoms were independently associated with longer pre-hospital delays. Future studies of pre-hospital delay should examine the mechanisms underlying this association.
Source: PLoS ONE
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,382
Awards: G1390233942, G1597930580, G2035115964, MIND-BODY-BEHAVIORAL MED CLINICAL TRIALS INFRASTRUCTURE, G2218269368, Clinical and Translational Science Award, G3041236093, G3269943612, Psychosocial Factors and Cardiovascular Disease, Cardiovascular Disease: Depression and Telomere Length, Midcareer Mentoring in Behavioral Cardiology: Depression & Cardiovascular Disease, G503572761, Comparison of Depression Interventions after Acute Coronary Syndrome (CODIACS), G5351273234, G560998863, Depression Screening RCT in ACS patients: Quality of Life and Cost Outcomes, G6142935640, RCT of Controlled Breathing Effects on Ambulatory BP, G7235562252, Reducing Vulnerability to ICD Shock Treated Ventricular Arrhythmias, G788201164, Physical Activity, Depression, and Post-ACS Survival, Depression, Biobehavioral Mechanisms, & CHD/Mortality Outcomes, G9000207826, G9000229683, Postdoctoral Training in Cardiovascular Disease
OpenAlex ID: W1992995596