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Symptoms of Posttraumatic Stress Disorder in Patients Who Have Had a Myocardial Infarction

Received October 15, 2004; revised January 21, June 20, 2005; accepted August 9, 2005. From the Depts. of Psychiatry and Pediatrics, Mount Sinai Medical Center, NY; the Hematology Institute and the Dept. of Cardiology, Assaf-Harofeh Medical Center, Zerifin, Sackler Faculty of Medicine, Tel Aviv Univ., Israel; and Duke University Medical Center, Durham, NC. Address correspondence and reprint requests to Dr. Shemesh, Mount Sinai Medical Center, Box 1230, 1 Gustave L. Levy Place, New York, NY 10029. e-mail: eyal.shemesh{at}mssm.edu

Symptoms of posttraumatic stress disorder (PTSD) and risk factors for recurrent ischemia were evaluated in 65 survivors of a myocardial infarction (MI) at baseline and 6 months afterward. PTSD patients had more uncontrolled cardiovascular risk factors at baseline. Patients with PTSD (N=14) were offered trauma-focused cognitive-behavior treatment (CBT) plus a nonspecific intervention to improve adherence to medical recommendations. Adherence to aspirin improved in recipients of the nonspecific intervention (N=8); PTSD symptoms and cardiovascular risk improved in patients who received CBT (N=6). PTSD may be a treatable risk factor for poor post-MI outcome. Further research is needed to evaluate treatment options.

Key Words: Cardiology • Posttraumatic Stress Disorder

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