Beta Blocker Administration During Emergency Department Evaluation for Acute Coronary Syndrome Is Associated With Lower Posttraumatic Stress Symptoms 1‐Month Later

Meli, Laura; Shimbo, Daichi; Swan, Brendan; Edmondson, Donald; Sumner, Jennifer A.

doi:10.1002/jts.22195

Cited by 10 publications

(3 citation statements)

References 25 publications

(34 reference statements)

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“…Participants in the current report were enrolled in the study between November 2013 and February 2016. Prior work, focusing on acute stress (13), threat perception (14)(15)(16)(17)(18), posttraumatic stress disorder (19)(20)(21)(22)(23)(24), and the ED environment (25,26), within this cohort has been published. This is the first examination of sleep within this cohort.…”

Section: Methodsmentioning

confidence: 99%

Short Sleep Duration After Hospital Evaluation for Acute Coronary Syndrome Is Associated With Increased Risk of 6-Month Readmission

et al. 2019

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Objective: Hospital readmission following acute coronary syndrome (ACS) is associated with worsened patient outcomes and financial burden. Short sleep duration is a risk factor for cardiovascular events, and may therefore represent a behavioral factor that increases risk of adverse post-hospitalization outcomes. This study examined whether short sleep duration in the month after hospital evaluation for ACS is associated with 6-month all-cause emergency department (ED) and hospital readmission. Methods:The current analyses entail a secondary analysis of a larger prospective observational cohort study. Sleep duration during the month following hospital evaluation for ACS was assessed subjectively and dichotomized as short (<6 hours) or not short (≥6 hours). A Cox proportional hazards model was used to assess the association between short sleep duration during the month following ACS hospital evaluation and 6-month all-cause ED/hospital readmission.Results: A total of 576 participants with complete data were included in analyses. Approximately 34% of participants reported short sleep duration during the month following ACS evaluation. Short sleep duration was significantly associated with 6-month all-cause ED/hospital readmission (HR=2.03; 95% CI: 1.12-3.66) in the model adjusted for age, sex, race/ethnicity, clinical severity, cardiac and renal markers, depression, acute stress, and including a sleep duration × ACS status interaction.Conclusions: Short sleep duration following ACS hospital evaluation is prevalent, and is associated with increased risk of all-cause readmission within 6 months of discharge. Current findings suggest that short sleep duration is an important modifiable behavioral factor to consider following hospital evaluation for ACS.

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Section: Methodsmentioning

confidence: 99%

Short Sleep Duration After Hospital Evaluation for Acute Coronary Syndrome Is Associated With Increased Risk of 6-Month Readmission

et al. 2019

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“…Indeed, clinical trials reported that propanol treatment with memory reactivation therapy reduced PTSD symptoms [217,218]. Beta-blocker administration for the suspected acute coronary syndrome was also shown to reduce PTSD symptoms at 1-month follow-up [219]. However, research on the preventative effects of propranolol is contradictory.…”

Section: Potential Anti-inflammatory Therapeutic Approachesmentioning

confidence: 99%

The role of the immune system in posttraumatic stress disorder

et al. 2022

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Posttraumatic stress disorder (PTSD) develops in a subset of individuals upon exposure to traumatic stress. In addition to well-defined psychological and behavioral symptoms, some individuals with PTSD also exhibit elevated concentrations of inflammatory markers, including C-reactive protein, interleukin-6, and tumor necrosis factor-α. Moreover, PTSD is often co-morbid with immune-related conditions, such as cardiometabolic and autoimmune disorders. Numerous factors, including lifetime trauma burden, biological sex, genetic background, metabolic conditions, and gut microbiota, may contribute to inflammation in PTSD. Importantly, inflammation can influence neural circuits and neurotransmitter signaling in regions of the brain relevant to fear, anxiety, and emotion regulation. Given the link between PTSD and the immune system, current studies are underway to evaluate the efficacy of anti-inflammatory treatments in those with PTSD. Understanding the complex interactions between PTSD and the immune system is essential for future discovery of diagnostic and therapeutic tools.

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“…Additionally, certain medications administered during hospitalization for cardiovascular events may impact risk for subsequent PTSD. 25 Recent research demonstrated that individuals administered benzodiazepines in-hospital following acute coronary syndrome (ACS) were nearly 4 times more likely to develop PTSD in response to ACS than those not given benzodiazepines. 26 Benzodiazepines are commonly prescribed on demand during hospitalization following a medical trauma 27 ; understanding their impact on stroke-induced PTSD may have important implications for in-hospital PTSD risk screening.…”

Section: Introductionmentioning

confidence: 99%

Correlates of Skin Conductance Reactivity to Stroke-Related Trauma Reminders During Hospitalization for Stroke

et al. 2023

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Objective Although several risk factors for stroke-induced posttraumatic stress disorder (PTSD) have been identified, objective risk measures that can be detected in the acute aftermath of these events are needed. This study is the first to collect an objective measure of psychophysiological arousal—skin conductance (SC) reactivity to a trauma interview—in patients after stroke or transient ischemic attack (TIA) and investigate correlates of SC reactivity. Methods Mobile SC measurement during a resting baseline and standardized trauma interview was performed in-hospital in 98 individuals following stroke/TIA. We examined associations between several stroke-induced PTSD risk factors (sociodemographic, psychosocial, and medical characteristics) and SC reactivity to a trauma interview involving a free-response recalling of the stroke/TIA event. Results Of the sociodemographic, psychosocial, medical characteristics examined as correlates to SC reactivity to recalling the stroke/TIA event, 2 factors reflecting aspects of prior and in-hospital experience were significantly associated with this indicator of sympathetic nervous system activation. A greater cumulative trauma burden was significantly associated with greater SC reactivity ( r = .23, P = .04). Additionally, individuals administered benzodiazepines in-hospital had significantly greater SC reactivity to recalling the stroke/TIA event ( M = 1.51, SD = 1.52) than those who were not ( M = 0.76, SD = 1.16; P = .01). Greater cumulative trauma burden remained significantly associated with greater SC reactivity when adjusting for age and in-hospital benzodiazepine administration ( β=0.22, P = .04). Conclusion This study demonstrated that SC reactivity was related to both behavioral and psychological risk factors for PTSD after a stroke/TIA event. Additionally, we demonstrated the feasibility of a low-cost, mobile measurement of SC that can be conducted in-hospital in a novel patient population: individuals with a medical trauma. With this measure, we were able to identify those individuals with the greatest trauma-related sympathetic nervous system reactivity in the days following a medical trauma. Future research is needed to determine whether SC reactivity may be leveraged in the development of brief, noninvasive screening measures for enhancing PTSD risk prediction.

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Beta Blocker Administration During Emergency Department Evaluation for Acute Coronary Syndrome Is Associated With Lower Posttraumatic Stress Symptoms 1‐Month Later

Cited by 10 publications

References 25 publications

Short Sleep Duration After Hospital Evaluation for Acute Coronary Syndrome Is Associated With Increased Risk of 6-Month Readmission

Short Sleep Duration After Hospital Evaluation for Acute Coronary Syndrome Is Associated With Increased Risk of 6-Month Readmission

The role of the immune system in posttraumatic stress disorder

Correlates of Skin Conductance Reactivity to Stroke-Related Trauma Reminders During Hospitalization for Stroke

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