Post-traumatic Stress Disorder (PTSD) and Coronary Artery Cardiac (CAC) Score

Abstract

Introduction: PTSD is associated with increased cardiovascular disease above and beyond classic risk factors and may be related to greater atherosclerotic burden. CAC is a radiographically-derived measure that correlates with the extent of atherosclerosis and is an independent predictor of subsequent cardiovascular events. Purpose: To determine if high CAC scores in a PTSD population of Australian veterans explained the known excess CVD risk. Methods: Male war veterans were recruited had baseline risk factors evaluated and diagnosis of current or past history of PTSD was made by a psychiatrist. CAC was assessed by cardiac CT scan. Continuous demographics and risk factors were compared between groups by t-test and categories by Fisher's exact test. Of the 296 participants, 159 (53.7%) met DSM-V criteria for PTSD and 137 (46.3%) were controls. Results:Tabled 1Demographics and risk factorsNo PTSDn=137PTSDn=159P-valueAge (years)69.2 ± 4.1368.5 ± 4.210.14Systolic blood pressure (mmHg)143 ± 17.7141 ± 17.10.17Triglycerides (Trigs)1.38 ± 0.5831.76 ± 1.280.001High density lipoprotein (HDL)1.3 ± 0.3251.22 ± 0.418(n=158)0.007Low density lipoprotein (LDL)3.01 ± 1.042.79 ± 1.02(n=155)0.07Current smoker7 (5.1%)19 (11.9%)0.04CAC category0.600-1028 (20.4%)37 (23.3%)>=10-10031 (22.6%)28 (17.6%)>=100 to 30032 (23.4%)32 (20.1%)>=30028 (20.4%)33 (20.8%)Known coronary artery disease18 (13.1%)29 (18.2%) Open table in a new tab Conclusions: Apart from Trigs, HDL and smoking status which were statistically but not clinically worse in the PTSD group, other classic risk factors (eg LDL) were similar between groups and likewise there was no significant difference in CAC category between those with and without PTSD. The greater CVD risk in PTSD is likely due to factors that contribute to instability of atherosclerotic plaque and triggers of rupture rather than calcified plaque burden per se.