Posttraumatic stress syndromes and health-related quality of life following myocardial infarction: 8-year follow-up

Objectives: This study examines the implications of acute stress disorder (ASD), following myocardial infraction (MI), in predicting subsequent posttraumatic stress disorder (PTSD) and impaired quality of life (QoL) 8 years post-MI. Methods: MI patients, who were assessed within a week of the MI (Time I; n=173), were followed up 7 months (Time 2; n=116) and 8 years (Time 3; n=90) post-MI. ASD was assessed at Time 1 and PTSD at Time 2 and Time 3. Health-related QoL was assessed at Time 3. Results: Unconditional latent class growth models revealed two distinct subpopulations: the recovered/resilient group (94%) demonstrated a decrease from 12.4% of ASD at Time 1 to 6.1% of PTSD at Time 3. Rates of posttraumatic stress syndromes in the chronic group (6%) were 85.3% at Time I and 75.7% at Time 3. The two groups differed in pre-MI life events, length of hospitalization, likelihood to have anterior MI, and perceived threat of death. The chronic group reported lower levels of QoL at Time 3. Conclusion: Although most ASD patients demonstrate a trend of recovery, ASD in the immediate aftermath of MI remains a marker of long term adjustment difficulties. (C) 2011 Elsevier Inc. All rights reserved.