Acute coronary syndrome [ACS, including unstable angina (UA) or myocardial infarction (MI)] events can be psychologically traumatic experiences for patients given their unpredictable, sudden onset and life-threatening nature [1]. Although posttraumatic stress disorder (PTSD) is commonly associated with index events of war or assault, PTSD is also associated with life-threatening illness and in particular ACS with approximately 12% of patients developing PTSD [1] and [2].
PTSD due to ACS has a multitude of consequences, including increased risk of ACS recurrence and mortality [3] and [4] in addition to PTSD itself being a debilitating psychiatric condition. Sufferers of PTSD are burdened by symptoms that include re-experiencing the traumatic event via intrusive thoughts, flashbacks, or nightmares; avoiding reminders of the index event; persistent negative alterations in cognition and mood; or physiologic hyperarousal. As such, ACS-induced PTSD is likely associated with substantial detriment in quality of life (QOL). However, few studies have measured this association, and no study has investigated it among a general ACS population or longitudinally. Rather, prior studies were composed of ACS patients only in intensive care units (ICUs) or among armed-services veterans [5], [6] and [7] or are notable for limitations such as cross-sectional designs [5] and [7]
