title: Posttraumatic stress disorder and soluble cellular adhesion molecules at rest and in response to a trauma-specific interview in patients after myocardial infarction.
abstract: Posttraumatic stress disorder (PTSD) and circulating cellular adhesion molecules (CAMs) predict cardiovascular risk. We hypothesized a positive relationship between PTSD caused by myocardial infarction (MI) and soluble CAMs. We enrolled 22 post-MI patients with interviewer-rated PTSD and 22 post-MI patients with no PTSD. At 32±6months after index MI, all patients were re-scheduled to undergo the Clinician-Administered PTSD Scale (CAPS) interview and had blood collected to assess soluble CAMs at rest and after the CAPS interview. Relative to patients with no PTSD, those with PTSD had significantly higher levels of soluble vascular cellular adhesion molecule (sVCAM)-1 and intercellular adhesion molecule (sICAM)-1 at rest and, controlling for resting CAM levels, significantly higher sVCAM-1 and sICAM-1 after the interview. Greater severity of PTSD predicted significantly higher resting levels of sVCAM-1 and soluble P-selectin in patients with PTSD. At follow-up, patients with persistent PTSD (n=15) and those who had remitted (n=7) did not significantly differ in CAM levels at rest and after the interview; however, both these groups had significantly higher sVCAM-1 and sICAM-1 at rest and also after the interview compared to patients with no PTSD. Elevated levels of circulating CAMs might help explain the psychophysiologic link of PTSD with cardiovascular risk.
authors.affiliation: Department of General Internal Medicine, Inselspital, Bern University Hospital, Bern, Switzerland. roland.vonkaenel@insel.ch
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.forename: Chiara C
authors.initials: CC
authors.lastname: Abbas
authors.forename: Stefan
authors.initials: S
authors.lastname: Begré
authors.forename: Hugo
authors.initials: H
authors.lastname: Saner
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Gander
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Schmid
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications* / Q000523:psychology; D019007:P-Selectin / Q000097:blood*; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000097:blood* / Q000209:etiology / Q000523:psychology; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
chemical_list: D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1