创伤后应激障碍严重程度和心血管疾病结局的大幅下降
Joanne Salas1, Poorva Sheth2, Beth E Cohen3
1The Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine. 1402 South Grand Blvd, St. Louis, MO, United States; Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine, 1402 South Grand Blvd, St. Louis, MO, United States.
创伤后应激障碍 (PTSD) 严重程度的显著降低并没有改善退伍军人的心血管疾病 (CVD) 结果. 需要进一步的研究来证实这些发现,在多种不同患者群体的伴随性PTSD和CVD.
科学领域:
- 心脏病学 心脏病学
- 精神病学是一个精神病学.
- 公共卫生 公共卫生
背景情况:
- 创伤后应激障碍 (PTSD) 是心血管疾病 (CVD) 的已知危险因素.
- 虽然身体健康的改善通常与PTSD严重程度的降低有关,但对共发病病例中心血管疾病结果的影响尚不清楚.
- 这项研究调查了退伍军人人口中PTSD改善和心血管疾病结果之间的关系.
研究的目的:
- 确定PTSD症状的临床上有意义的改善是否与更好的心血管结果有关.
- 分析PTSD严重程度的降低与心肌梗塞,再血管化,全因死亡率和中风风险之间的关联.
- 通过种族,年龄或抑郁症来探索这种关联的潜在修改.
主要方法:
- 分析了7120名患有PTSD和并发性心血管疾病的退伍军人队伍,使用非身份化医疗记录 (2011-2022年).
- 临床上有意义的PTSD改善被定义为PTSD检查清单 (PCL) 上≥20点的下降.
- 通过平衡控制混的考克斯比例危险模型评估了PTSD改善和心血管疾病结果之间的关联.
主要成果:
- 在老兵样本中的20.4%观察到临床上有意义的PTSD改善.
- 在患有和没有临床意义上的PTSD改善的患者之间,在心肌梗塞/血管再循环的风险,全因死亡率或中风方面没有发现显著差异.
- 种族,年龄和抑郁症并没有显著改变PTSD改善和不良心血管疾病结果之间的关联.
结论:
- 在这组患有并发性PTSD和CVD的退伍军人中,PTSD严重程度的大幅度减少与改善或恶化心血管结果无关.
- 需要进行进一步的研究,以确定PTSD改善和心血管疾病结果之间的缺乏关联是否在其他患者群体中一致.
- 这些发现突显了老兵人口中心理健康和心血管健康之间的复杂相互作用.
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