Document Detail


Post-traumatic stress disorder and incidence of coronary heart disease: a twin study.
MedLine Citation:
PMID:  23810885     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to determine whether post-traumatic stress disorder (PTSD) is associated with coronary heart disease (CHD) using a prospective twin study design and objective measures of CHD.
BACKGROUND: It has long been hypothesized that PTSD increases the risk of CHD, but empirical evidence using objective measures is limited.
METHODS: We conducted a prospective study of middle-aged male twins from the Vietnam Era Twin Registry. Among twin pairs without self-reported CHD at baseline, we selected pairs discordant for a lifetime history of PTSD, pairs discordant for a lifetime history of major depression, and pairs without either condition. All underwent a clinic visit after a median follow-up of 13 years. Outcomes included clinical events (myocardial infarction, other hospitalizations for CHD and coronary revascularization) and quantitative measures of myocardial perfusion by [(13)N] ammonia positron emission tomography, including a stress total severity score and coronary flow reserve.
RESULTS: A total of 562 twins (281 pairs) with a mean age of 42.6 years at baseline were included in this study. The incidence of CHD was more than double in twins with PTSD (22.6%) than in those without PTSD (8.9%; p < 0.001). The association remained robust after adjusting for lifestyle factors, other risk factors for CHD, and major depression (odds ratio: 2.2; 95% confidence interval: 1.2 to 4.1). Stress total severity score was significantly higher (+95%, p = 0.001) and coronary flow reserve was lower (-0.21, p = 0.02) in twins with PTSD than in those without PTSD, denoting worse myocardial perfusion. Associations were only mildly attenuated in 117 twin pairs discordant for PTSD.
CONCLUSIONS: Among Vietnam-era veterans, PTSD is a risk factor for CHD.
Authors:
Viola Vaccarino; Jack Goldberg; Cherie Rooks; Amit J Shah; Emir Veledar; Tracy L Faber; John R Votaw; Christopher W Forsberg; J Douglas Bremner
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Twin Study     Date:  2013-06-27
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  62     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2013 Sep 
Date Detail:
Created Date:  2013-09-06     Completed Date:  2013-11-19     Revised Date:  2014-09-19    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  970-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Adult
Coronary Artery Disease / epidemiology*,  etiology,  mortality,  physiopathology
Diseases in Twins*
Follow-Up Studies
Health Surveys
Humans
Incidence
Male
Middle Aged
Myocardial Perfusion Imaging
Positron-Emission Tomography
Prospective Studies
Registries
Risk Factors
Stress Disorders, Post-Traumatic / complications*
Twins / statistics & numerical data*
Twins, Dizygotic
Twins, Monozygotic
United States / epidemiology
Veterans / statistics & numerical data*
Vietnam Conflict
Grant Support
ID/Acronym/Agency:
K24 HL077506/HL/NHLBI NIH HHS; K24 MH076955/MH/NIMH NIH HHS; K24 MH076955/MH/NIMH NIH HHS; K24HL077506/HL/NHLBI NIH HHS; M01 RR000039/RR/NCRR NIH HHS; MO1-RR00039/RR/NCRR NIH HHS; R01 AG026255/AG/NIA NIH HHS; R01 AG026255/AG/NIA NIH HHS; R01 HL068630/HL/NHLBI NIH HHS; R01 HL68630/HL/NHLBI NIH HHS; R21 HL093665/HL/NHLBI NIH HHS; R21HL093665-01A1S1/HL/NHLBI NIH HHS; UL1 TR000454/TR/NCATS NIH HHS; UL1TR000454/TR/NCATS NIH HHS
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2013 Sep 10;62(11):979-80   [PMID:  23810873 ]

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