The Prevalence and Influencing Factors of Posttraumatic Stress Disorder in Patients with Myocardial Infarction: A Systematic Review and Meta-analysis

Simin Li, Xiaoyue Wang, Fengyin Zhang, Qinghua Wen, Juan Li

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¹ School of Nursing, Zunyi Medical University, Zunyi, 563006, China,

² School of Public Health, Zunyi Medical University, 563006, China,

³ School of Nursing, Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, China,

⁴ Department of Nursing, Guizhou Provincial People’s Hospital, 550002, China,

JCNR 2025 , 9(5), 121–135; https://doi.org/10.26689/jcnr.v9i5.10723

© 2025 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

With the accelerated pace of population aging in China, the number of patients suffering from myocardial infarction (MI) is increasing annually. During disease progression, patients are at significantly higher risk of developing severe negative emotions, and emerging evidence suggests that post-traumatic stress disorder (PTSD) is significantly associated with cardiovascular disease, which seriously affects patients’ quality of life. Objective: The aim of this study was to comprehensively assess the prevalence and influencing factors of PTSD in MI patients through systematic review and Meta-analysis. Methods:A computerized search of PubMed, the Cochrane Library, Embase, Web of Science, PsycINFO, China Knowledge Network (CNKI), WanFang Data, VIP, and China Biomedical Literature Database (CBM) was conducted to collect longitudinal studies, case-control studies, and cross-sectional studies related to PTSD prevalence rates and influencing factors in MI patients published up to August 1,2024.Literature screening, data extraction and quality assessment were done independently by two researchers and Meta-analysis was done using Stata 16.0 software. This study has been registered on the PROSPERO platform, registration number: CRD42024577243. Results: A total of 16 papers were included, with a total sample size of 3,768 cases involving 8 influencing factors.The results of the Meta-analysis showed that the prevalence of PTSD in patients with MI was 20.4% (95% CI = 15.0–26.5%). Female (OR = 3.12, 95% CI = 1.97–4.97, P < 0.001), high neuroticism score (OR = 2.21, 95% CI = 1.20–4.07, P = 0.011), and high intrusive rumination score (OR = 2.95, 95% CI = 1.50–5.83, P = 0.002) were the risk factors for PTSD in MI patients. While age (OR = 1.01, 95% CI = 0.98–1.04, P = 0.440), education level (OR = 0.55, 95% CI = 0.07–4.48, P = 0.574), social support rating scale (OR = 0.81, 95% CI = 0.52–1.26, P = 0.346), Killip cardiac function classification (OR = 2.29, 95% CI = 0.91–5.80, P = 0.080) and creatine kinase isoenzyme (OR = 1.03, 95% CI = 0.99–1.05, P = 0.124) were not associated with the development of PTSD in MI patients. Conclusion: The prevalence of PTSD was higher in patients with MI. The prevalence varied by evaluation tool and study area. Risk factors were multifactorial, including general factors (female) and overall assessment (high neuroticism score, high invasive rumination score). Therefore, early intervention and proper de-escalation of PTSD symptoms in patients with MI by medical staff are needed in clinical practice to reduce the risk of PTSD.

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