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Acute Stress Disorder Symptoms Predict All-Cause Mortality Among Myocardial Infarction Patients: a 15-Year Longitudinal Study

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Annals of Behavioral Medicine

Abstract

Background

Studies have recognized myocardial infarction (MI) as a risk for acute stress disorder (ASD), manifested in dissociative, intrusive, avoidant, and hyperarousal symptoms during hospitalization.

Purpose

This study examined the prognostic role of ASD symptoms in predicting all-cause mortality in MI patients over a period of 15 years.

Methods

One hundred and ninety-three MI patients filled out questionnaires assessing ASD symptoms during hospitalization. Risk factors and cardiac prognostic measures were collected from patients’ hospital records. All-cause mortality was longitudinally assessed, with an endpoint of 15 years after the MI.

Results

Of the participants, 21.8 % died during the follow-up period. The decedents had reported higher levels of ASD symptoms during hospitalization than had the survivors, but this effect became nonsignificant when adjusting for age, sex, education, left ventricular ejection fraction, and depression. A series of analyses conducted on each of the ASD symptom clusters separately indicated that—after adjusting for age, sex, education, left ventricular ejection fraction, and depression—dissociative symptoms significantly predicted all-cause mortality, indicating that the higher the level of in-hospital dissociative symptoms, the shorter the MI patients’ survival time.

Conclusion

These findings suggest that in-hospital dissociative symptoms should be considered in the risk stratification of MI patients.

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Funding

This study was partially supported by the Sarah Peleg Research Foundation and by the Chief Scientist of the Israeli Ministry of Health.

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Karni Ginzburg, Ilan Kutz, Bella Koifman, Arie Roth, Michael Kriwisky, Daniel David, and Avi Bleich declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

Author information

Authors and Affiliations

  1. The Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, 69978, Israel

    Karni Ginzburg PhD

  2. Private Practice, Tel Aviv, Israel

    Ilan Kutz MD

  3. Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel

    Bella Koifman MD & Arie Roth MD

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Bella Koifman MD, Arie Roth MD & Avi Bleich MD

  5. Department of Cardiology, Edith Wolfson Medical Center, Tel Aviv, Israel

    Michael Kriwisky MD

  6. Department of Cardiology, Meir General Hospital, Kfar Saba, Israel

    Daniel David MD

  7. Lev Hasharon Psychiatric Hospital, Tzur Moshe, Israel

    Avi Bleich MD

Authors
  1. Karni Ginzburg PhD
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  2. Ilan Kutz MD
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  3. Bella Koifman MD
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  4. Arie Roth MD
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  5. Michael Kriwisky MD
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  6. Daniel David MD
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  7. Avi Bleich MD
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Corresponding author

Correspondence to Karni Ginzburg PhD.

Additional information

Dr. Arie Roth is deceased.

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Ginzburg, K., Kutz, I., Koifman, B. et al. Acute Stress Disorder Symptoms Predict All-Cause Mortality Among Myocardial Infarction Patients: a 15-Year Longitudinal Study. ann. behav. med. 50, 177–186 (2016). https://doi.org/10.1007/s12160-015-9744-x

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