title: Measures of endothelial dysfunction in plasma of patients with posttraumatic stress disorder.
abstract: Posttraumatic stress disorder (PTSD) confers an increased cardiovascular risk. In 14 otherwise healthy patients with PTSD and in 14 age- and gender-matched non-PTSD controls, we investigated whether the categorical diagnosis of PTSD and severity of PTSD symptom clusters (i.e. re-experiencing, avoidance, arousal, and overall score) would be associated with plasma concentrations of three markers of endothelial dysfunction [soluble tissue factor (sTF), von Willebrand factor (VWF), and soluble intercellular adhesion molecule (sICAM)-1]. Compared with controls, patients had significantly higher sTF; this difference became nonsignificant when controlling for psychological distress. VWF and sICAM-1 levels were not significantly different between patients and controls. In the entire sample virtually all PTSD symptom clusters correlated significantly and positively with sTF and VWF but not with sICAM-1. The correlation between symptoms of re-experiencing and sTF was significantly different between patients and controls. Controlling for symptoms of anxiety and depression (i.e. psychological distress) rendered most associations between PTSD symptom clusters and sTF nonsignificant, whereas controlling for age retained significance of associations with VWF. Posttraumatic stress showed a continuous relationship with sTF and VWF, with the former relationship being partly affected by psychological distress. This suggests one mechanism by which posttraumatic stress could contribute to atherosclerosis.
authors.affiliation: Department of General Internal Medicine, Division of Psychosomatic Medicine, University Hospital Berne, Switzerland. roland.vonkaenel@insel.ch <roland.vonkaenel@insel.ch>
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Urs
authors.initials: U
authors.lastname: Hepp
authors.forename: Rafael
authors.initials: R
authors.lastname: Traber
authors.forename: Bernd
authors.initials: B
authors.lastname: Kraemer
authors.forename: Ladislav
authors.initials: L
authors.lastname: Mica
authors.forename: Marius
authors.initials: M
authors.lastname: Keel
authors.forename: Brent T
authors.initials: BT
authors.lastname: Mausbach
authors.forename: Ulrich
authors.initials: U
authors.lastname: Schnyder
mesh_terms: D000328:Adult; D000367:Age Factors; D050197:Atherosclerosis / Q000097:blood / Q000209:etiology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D016000:Cluster Analysis; D035061:Control Groups; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood* / Q000502:physiology; D008016:Life Change Events; D008019:Life Style; D008297:Male; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012307:Risk Factors; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D013315:Stress, Psychological / Q000097:blood / Q000503:physiopathology; D013925:Thromboplastin / Q000032:analysis* / Q000502:physiology; D014841:von Willebrand Factor / Q000032:analysis* / Q000502:physiology
chemical_list: D015415:Biomarkers; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1; D013925:Thromboplastin