August 21, 2018
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PTSD increases risk for mortality in men with HFrEF

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Nearly 10% of men who were veterans with HF with reduced ejection fraction also had PTSD, according to a study published in The American Journal of Cardiology.

Marat Fudim, MD, cardiology fellow at Duke University Medical Center, and colleagues analyzed data from 111,970 men with HFrEF who were treated within the Veterans Affairs Health System from January 2007 to January 2015. These patients were also taking beta-blockers such as carvedilol, succinate and metoprolol concomitantly.

Patients were followed up from the initial fill date for beta-blockers until death or the end of the study period for a mean of 3.5 years.

Of the patients from this study, 9.9% also had PTSD. Compared with patients without PTSD, those with PTSD were more likely to be younger (64 years vs. 69 years) and have higher rates of chronic obstructive lung disease (42% vs. 31%; P < .01), CAD (73% vs. 64%; P < .01) and hypertension (80% vs. 64%; P < .01).

Patients with HFrEF and PTSD were also more likely to be taking high-dose beta-blockers (70% vs. 68%; P < .01) and ACE inhibitors (96% vs. 93%; P < .01).

At 7 years, patients with PTSD had a significantly increased risk for mortality vs. those without PTSD (adjusted HR = 1.54; 95% CI, 1.3-1.82).

The link between PTSD and outcomes did not change significantly after adjusting for the degree of health care utilization.

“Given the high burden of PTSD and the associated risk, more attention needs to be paid to patients who have PTSD,” Fudim and colleagues wrote. “Prospective research is needed to better elucidate the factors responsible for these findings and to identify ways to improve outcomes in this high-risk population.” – by Darlene Dobkowski

Disclosures: Fudim reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.