Post-Traumatic Growth and Post-Traumatic Stress Disorder in Acute Myocardial Infarction among Younger and Older Adults: A Retrospective Cohort Study.

backgroundWhile the physical implications of acute myocardial infarction (AMI) have been extensively studied, its psychological aspects, particularly post-traumatic growth (PTG) and post-traumatic stress disorder (PTSD) have gained increasing attention. This retrospective cohort study aimed to investigate the correlations between age, PTG, and PTSD in the context of AMI.

methodsA total of 250 cases of patients with AMI were included in the study, sourced from the coronary care unit of Hanzhong Central Hospital and followed up in the outpatient department from January 2017 to June 2023. The data collection for this study was conducted from July 2023 to August 2023. Patients were divided into two groups based on their age at the time of AMI: 148 patients in the Younger group (≤45 years) and 102 patients in the Older group (>45 years). The patients were assessed for PTSD using the PTSD Checklist-Civilian Version (PCL-C) and for PTG using the Posttraumatic Growth Inventory (PTGI). Statistical analysis was conducted to examine the correlations and associations between age and PTG and PTSD symptoms.

resultsThe findings revealed significant age-related variations in PTSD symptomatology and PTG following AMI. Older adults exhibited higher re-experience (p < 0.001), lower hyperarousal (p = 0.023), and lower avoidance/numbing (p = 0.037) symptoms compared to younger adults, along with decreased scores in PTG domains such as relating to others (p < 0.001), appreciation of life (p < 0.001), spiritual change (p < 0.001), and personal strength (p < 0.001). The correlation analysis further demonstrated that age was significantly positively correlated with re-experience (r = 0.366, p < 0.001) and negatively correlated with avoidance/numbing (r = -0.129, p = 0.041), hyperarousal (r = -0.154, p = 0.015), relating to others (r = -0.393, p < 0.001), appreciation of life (r = -0.256, p < 0.001), spiritual change (r = -0.285, p < 0.001), and personal strength (r = -0.460, p < 0.001). Linear regression analysis showed that for every year increase in age, the beta coefficient for re-experience was 0.369 (Standard Error (SE) = 0.051, t = 7.18, p < 0.001, 95% Confidence Interval (CI) [0.266, 0.466]), indicating a significant positive association. Conversely, age had significant negative associations with avoidance/numbing (β = -0.131, SE = 0.061, t = -2.11, p = 0.036, 95% CI [-0.249, -0.009]), hyperarousal (β = -0.158, SE = 0.067, t = -2.30, p = 0.022, 95% CI [-0.286, -0.022]), relating to others (β = -0.391, SE = 0.047, t = -8.36, p < 0.001, 95% CI [-0.485, -0.301]), appreciation of life (β = -0.263, SE = 0.058, t = -4.41, p < 0.001, 95% CI [-0.370, -0.142]), spiritual change (β = -0.282, SE = 0.054, t = -5.28, p < 0.001, 95% CI [-0.391, -0.179]), and personal strength (β = -0.464, SE = 0.049, t = -9.39, p < 0.001, 95% CI [-0.556, -0.364]).

conclusionsThe study underscores the importance of adopting a multidimensional approach to patient care following AMI, tailored interventions to address the specific needs of younger and older adults, and the need for age-specific psychological assessment and intervention strategies in the management of patients recovering from AMI.