Continuous variables of Non-PTSD patients and PTSD patients with acute MI were presented in Table 1. The age, heart rate, number of stents, urea nitrogen, WBC counts, CK-MB, myoglobin, Troponin I, BNP, TC, triglyceride, HDL-C, LDL-C, Apolipoprotein A and Apolipoprotein B were significantly higher in PTSD patients with acute MI. than those in non-PTSD patients with acute MI. Meanwhile, the BMI, waist circumference, smoking index, systolic pressure, diastolic pressure, creatinine, RBC counts, hemoglobin, platelet counts, TBIL, albumin, HbA1c, LVEF were not significantly different in PTSD patients with acute MI and non-PTSD patients with acute MI.
Table 1
Continuous variables of Non-PTSD patients and PTSD patients with acute MI
| Non-PTSD (n = 203) | PTSD (n = 97) | P value |
Age (years) | 58.92 ± 11.29 | 63.32 ± 12.33 | 0.006* |
BMI (kg/m2) | 24.49 ± 2.91 | 25.33 ± 3.23 | 0.055 |
Waist circumference (cm) | 91.63 ± 15.18 | 92.04 ± 14.62 | 0.670 |
Smoking index | 292.44 ± 401.91 | 300.47 ± 420.12 | 0.966 |
Systolic pressure (mmHg) | 129.86 ± 17.58 | 131.54 ± 22.19 | 0.716 |
Diastolic pressure (mmHg) | 79.19 ± 11.11 | 80.09 ± 15.41 | 0.964 |
Heart rate (beats/min) | 77.00 ± 14.86 | 81.06 ± 15.69 | 0.040* |
Number of stents | 1.39 ± 0.608 | 1.75 ± 0.80 | 0.001* |
Urea nitrogen (mmol/L) | 5.89 ± 5.05 | 6.03 ± 2.14 | 0.008* |
Creatinine (umol/L) | 82.19 ± 74.96 | 76.24 ± 28.71 | 0.818 |
WBC counts (× 109/L) | 8.66 ± 2.75 | 9.91 ± 3.40 | 0.001* |
RBC counts (× 1012/L) | 4.47 ± 0.62 | 4.54 ± 0.63 | 0.461 |
Hemoglobin (g/L) | 138.61 ± 17.65 | 139.72 ± 21.52 | 0.556 |
Platelet counts (× 109/L) | 211.87 ± 84.69 | 227.14 ± 78.40 | 0.085 |
CK-MB (U/L) | 35.97 ± 58.58 | 85.34 ± 95.37 | < 0.001* |
Myoglobin (ug/L) | 206.22 ± 413.80 | 520.24 ± 862.95 | < 0.001* |
Troponin I (ug/L) | 5.08 ± 10.39 | 16.96 ± 18.38 | < 0.001* |
BNP (pg/mL) | 359.38 ± 516.46 | 590.67 ± 762.50 | 0.003* |
TBIL (umol/L) | 21.05 ± 16.83 | 18.68 ± 11.49 | 0.164 |
Albumin (g/L) | 37.12 ± 3.48 | 38.29 ± 5.78 | 0.110 |
TC (mmol/L) | 3.73 ± 0.90 | 4.99 ± 1.11 | < 0.001* |
Triglyceride (mmol/L) | 1.59 ± 1.07 | 1.87 ± 1.03 | < 0.001* |
HDL-C (mmol/L) | 0.96 ± 0.21 | 1.14 ± 0.30 | < 0.001* |
LDL-C (mmol/L) | 2.25 ± 0.75 | 3.17 ± 0.87 | < 0.001* |
Apolipoprotein A (g/L) | 1.09 ± 0.21 | 1.22 ± 0.27 | < 0.001* |
Apolipoprotein B (g/L) | 0.81 ± 0.20 | 1.04 ± 0.23 | < 0.001* |
HbA1c (%) | 6.13 ± 1.38 | 6.29 ± 1.59 | 0.190 |
LVEF (%) | 55.13 ± 8.69 | 53.73 ± 10.71 | 0.544 |
PTSD score | 36.08 ± 7.81 | 57.46 ± 6.63 | < 0.001* |
Note: PTSD Post-Traumatic Stress Disorder, MI Myocardial Infarction, BMI body mass index, WBC White Blood Cells, RBC Red Blood Cells, CK-MB Creatine Kinase-MB, BNP Brain Natriuretic Peptide, TBIL Total Bilirubin, TC Total Cholesterol, HDL-C High-Density Lipoprotein-Cholesterol, LDL-C Low-Density Lipoprotein-Cholesterol, HbA1c glycosylated Hemoglobin A1c, LVEF left ventricular ejection fraction, *P < 0.05 |
Categorical variables of Non-PTSD patients and PTSD patients with acute MI were presented in Table 2. The IABP implantation and use of diuretic in PTSD patients with acute MI were significantly higher than those in non-PTSD patients with acute MI. While the sex, hypertension, atrial fibrillation, diabetes mellitus, classification of MI, primary PCI, thrombus aspiration, stent implantation, temporary pacemaker implantation, aspirin, clopidogrel, ticagrelor, tirofiban, norepinephrine, dopamine, calcium, antagonist, β-blockers ACEI/ARB, nitrates, intracoronary sodium nitroprusside and intracoronary urokinase showed no significant difference in PTSD patients with acute MI and non-PTSD patients with acute MI.
Table 2
Categorical variables of Non-PTSD patients and PTSD patients with acute MI
| Non-PTSD (n = 203) | PTSD (n = 97) | P value |
Sex (%) | | | 0.491 |
men | 148 (72.9%) | 67 (69.1%) | |
women | 55 (27.1%) | 30 (30.9%) | |
Hypertension (%) | 109 (53.7%) | 51 (52.6%) | 0.856 |
Atrial fibrillation (%) | 5 (2.5%) | 2 (2.1%) | 1.000 |
Diabetes mellitus (%) | 39 (19.2%) | 20 (20.6%) | 0.774 |
Classification of MI (%) | | | 0.222 |
STEMI | 136 (67.0%) | 58 (59.8%) | |
NSTEMI | 67 (33.0%) | 39 (40.2%) | |
Primary PCI (%) | 37 (18.2%) | 11 (11.3%) | 0.128 |
Thrombus aspiration (%) | 20 (9.9%) | 7 (7.2%) | 0.456 |
Stent implantation (%) | 140 (69.7%) | 59 (60.8%) | 0.130 |
IABP implantation (%) | 8 (3.9%) | 13 (13.4%) | 0.003* |
Temporary pacemaker implantation (%) | 16 (7.9%) | 6 (6.2%) | 0.598 |
Aspirin (%) | 203 (100%) | 97 (100%) | 1.000 |
Clopidogrel (%) | 185 (91.1%) | 89 (91.8%) | 0.858 |
Ticagrelor (%) | 65 (32.0%) | 28 (28.9%) | 0.581 |
Tirofiban (%) | 67 (33.0%) | 26 (26.8%) | 0.277 |
Norepinephrine (%) | 28 (13.8%) | 8 (8.2%) | 0.176 |
Dopamine (%) | 19 (9.4%) | 9 (9.3%) | 0.982 |
Calcium antagonist (%) | 24 (11.8%) | 8 (8.2%) | 0.348 |
β-blockers (%) | 179 (88.2%) | 86 (88.7%) | 0.903 |
ACEI/ARB (%) | 174 (85.7%) | 85 (87.6%) | 0.752 |
Diuretic (%) | 66 (32.5%) | 45 (46.4%) | 0.020* |
Nitrates (%) | 134 (66.0%) | 68 (70.1%) | 0.480 |
Intracoronary sodium nitroprusside (%) | 12 (5.9%) | 8 (8.2%) | 0.448 |
Intracoronary urokinase (%) | 2 (1.0%) | 0 (0.0%) | 1.000 |
Note: PTSD Post-Traumatic Stress Disorder, MI Myocardial Infarction, STEMI ST-segment Elevation Myocardial Infarction, NSTEMI Non ST-segment Elevation Myocardial Infarction, PCI Percutaneous Coronary Intervention, IABP Intra-Aortic Balloon Pump, ACEI Angiotension Converting Enzyme Inhibitor, ARB Angiotensin Receptor Blockers, *P < 0.05 |
Pearson correlation analysis between PTSD score and continuous confounding factors in patients with acute MI were in Table 3. The age, BMI, heart rate, number of stents, urea nitrogen, WBC counts, CK-MB, myoglobin, Troponin I, BNP, TC, triglyceride, HDL-C, LDL-C, apolipoprotein A and apolipoprotein B were significantly and positively correlated with PTSD score. Meanwhile, the waist circumference, smoking index, systolic pressure, diastolic pressure, creatinine, RBC counts, hemoglobin, platelet counts, TBIL, albumin, HbA1c and LVEF were not linearly correlated with PTSD score in our population.
Table 3
Pearson correlation analysis between PTSD score and continuous confounding factors in patients with acute MI
| r | P value |
Age | 0.233 | < 0.001* |
BMI | 0.125 | 0.030* |
Waist circumference | -0.058 | 0.318 |
Smoking index | 0.038 | 0.516 |
Systolic pressure | 0.084 | 0.149 |
Diastolic pressure | 0.041 | 0.483 |
Heart rate | 0.141 | 0.015* |
Number of stents | 0.236 | 0.001* |
Urea nitrogen | 0.131 | 0.024* |
Creatinine | 0.004 | 0.940 |
WBC counts | 0.147 | 0.011* |
RBC counts | -0.050 | 0.385 |
Hemoglobin | -0.078 | 0.176 |
Platelet counts | 0.057 | 0.328 |
CK-MB | 0.304 | < 0.001* |
Myoglobin | 0.271 | < 0.001* |
Troponin I | 0.421 | < 0.001* |
BNP | 0.278 | < 0.001* |
TBIL | -0.101 | 0.088 |
Albumin | 0.110 | 0.063 |
TC | 0.546 | < 0.001* |
Triglyceride | 0.136 | 0.022* |
HDL-C | 0.323 | < 0.001* |
LDL-C | 0.517 | < 0.001* |
Apolipoprotein A | 0.235 | < 0.001* |
Apolipoprotein B | 0.502 | < 0.001* |
HbA1c | 0.054 | 0.436 |
LVEF | -0.105 | 0.094 |
Note: PTSD Post-Traumatic Stress Disorder, MI Myocardial Infarction, BMI body mass index, WBC White Blood Cells, RBC Red Blood Cells, CK-MB Creatine Kinase-MB, BNP Brain Natriuretic Peptide, TBIL Total Bilirubin, TC Total Cholesterol, HDL-C High-Density Lipoprotein-Cholesterol, LDL-C Low-Density Lipoprotein-Cholesterol, HbA1c glycosylated Hemoglobin A1c, LVEF left ventricular ejection fraction, *P < 0.05 |
Logistic regression analysis for PTSD using confounding factors in patients with acute MI was in Table 4. The continuous factors which showed difference between the two groups of population, and the factors which significantly correlated with PTSD score were enrolled in Logistic regression, the significantly different categorical variables were also enrolled in the Logistic regression for analysis. After the adjustment of the confounding factors, the number of stents was significantly associated with PTSD in acute MI patients (OR = 4.131, P = 0.003), meanwhile we also documented the Troponin I and BNP were also significantly associated with PTSD in acute MI patients (OR = 1.066, P = 0.046; OR = 1.002, P = 0.019; respectively).
Table 4
Logistic regression analysis for PTSD using confounding factors in patients with acute MI
| OR | 95% CI | P value |
Age | 1.076 | 0.996–1.163 | 0.063 |
Heart rate | 0.987 | 0.942–1.035 | 0.597 |
Number of stents | 4.131 | 1.599–10.677 | 0.003* |
IABP implantation | 7.406 | 0.792–69.290 | 0.079 |
Diuretic | 0.399 | 0.080–1.998 | 0.263 |
Urea nitrogen | 1.028 | 0.903–1.171 | 0.673 |
WBC | 0.871 | 0.642–1.182 | 0.374 |
CK-MB | 1.008 | 0.993–1.022 | 0.296 |
Myoglobin | 1.001 | 1.000-1.002 | 0.249 |
Troponin I | 1.066 | 1.001–1.136 | 0.046* |
BNP | 1.002 | 1.000-1.003 | 0.019* |
TC | 3.481 | 0.475–25.54 | 0.220 |
Triglyceride | 1.471 | 0.537–4.029 | 0.453 |
HDL-C | 0.277 | 0.001-233.404 | 0.709 |
LDL-C | 0.594 | 0.077–4.604 | 0.618 |
Apolipoprotein A | 23.429 | 0.046-11949.87 | 0.321 |
Apolipoprotein B | 224.563 | 0.178-283219.66 | 0.137 |
Note: PTSD Post-Traumatic Stress Disorder, MI Myocardial Infarction, CI Confidence Interval, IABP Intra-Aortic Balloon Pump, WBC White Blood Cells, CK-MB Creatine Kinase-MB, BNP Brain Natriuretic Peptide, TC Total Cholesterol, HDL-C High-Density Lipoprotein-Cholesterol, LDL-C Low-Density Lipoprotein-Cholesterol, *P < 0.05 |
PTSD score in acute MI patients with different number of stents implanted were presented in Fig. 1. The PTSD score showed the increase trend as the number of stents implanted increased, the PTSD score were 39.72 ± 11.12, 44.85 ± 13.46, 47.69 ± 9.39 and 49.33 ± 18.14 in acute MI patients with 1, 2, 3 and 4 stents respectively. The PTSD score showed significant difference in acute MI patients with different number of stents implanted (P = 0.008). The comparison between the groups showed that the significant difference of PTSD scores may come from the PTSD scores variation in patients with 1 stent vs. 2 stents (P = 0.006), and also in patients with 1 stent vs. 3 stents (P = 0.023).