{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T09:28:12Z","timestamp":1793179692503,"version":"4.5.0"},"reference-count":48,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,1,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Benzodiazepines and morphine are given during acute coronary syndromes (ACSs) to alleviate anxiety and pain, and \u03b2\u2010blockers may also reduce pain. ACS may induce posttraumatic stress disorder (PTSD) symptoms (PTSS). When taken during trauma other than ACS, benzodiazepines increase the risk of PTSS, but it is unknown if benzodiazepines increase the risk of PTSS in ACS. We examined the effects of drug exposure during ACS on the development of PTSS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Study participants were 154 patients with a verified ACS. Baseline demographics, clinical variables, and psychological measures were obtained through a medical history, through a psychometric assessment, and from patient records, and used as covariates in linear regression analysis. Three months after ACS, the severity of PTSS was assessed with the Clinician\u2010Administered PTSD Scale. During ACS, 37.7% of patients were exposed to benzodiazepines, whereas 72.1% were exposed to morphine and 88.3% were exposed to \u03b2\u2010blockers, but only 7.1% were exposed to antidepressants. Eighteen (11.7%) patients developed clinical PTSD. Adjusting for all covariates, benzodiazepine use was significantly associated with the Clinician\u2010Administered PTSD Scale total severity score (unstandardized coefficient B [SE], 0.589 [0.274]; partial\n                      <jats:italic>r<\/jats:italic>\n                      =0.18;\n                      <jats:italic>P<\/jats:italic>\n                      =0.032) and the reexperiencing subscore (B [SE], 0.433 [0.217]; partial\n                      <jats:italic>r<\/jats:italic>\n                      =0.17;\n                      <jats:italic>P<\/jats:italic>\n                      =0.047). Patients exposed to benzodiazepines had an almost 4\u2010fold increased relative risk of developing clinical PTSD, adjusting for acute stress disorder symptoms (odds ratio, 3.75; 95% CI, 1.31\u201310.77). Morphine, \u03b2\u2010blockers, and antidepressants showed no predictive value.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Notwithstanding short\u2010term antianxiety effects during ACS, benzodiazepine use might increase the risk of ACS\u2010induced PTSS with clinical significance, thereby compromising patients' quality of life and prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT01781247.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.018762","type":"journal-article","created":{"date-parts":[[2021,1,12]],"date-time":"2021-01-12T14:24:28Z","timestamp":1610461468000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Pharmacotherapy in the Management of Anxiety and Pain During Acute Coronary Syndromes and the Risk of Developing Symptoms of Posttraumatic Stress Disorder"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8929-5129","authenticated-orcid":false,"given":"Roland","family":"von K\u00e4nel","sequence":"first","affiliation":[{"name":"Department of Consultation\u2010Liaison Psychiatry and Psychosomatic Medicine University Hospital ZurichUniversity of Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Paul","family":"Schmid","sequence":"additional","affiliation":[{"name":"Department of Cardiology Clinic Barmelweid Barmelweid Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca E.","family":"Meister\u2010Langraf","sequence":"additional","affiliation":[{"name":"Department of Consultation\u2010Liaison Psychiatry and Psychosomatic Medicine University Hospital ZurichUniversity of Zurich Switzerland"},{"name":"Clienia Schl\u00f6ssli AG Oetwil am See, Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Barth","sequence":"additional","affiliation":[{"name":"Complementary and Integrative Medicine University Hospital ZurichUniversity of Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hansj\u00f6rg","family":"Znoj","sequence":"additional","affiliation":[{"name":"Department of Health Psychology and Behavioral Medicine University of Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Schnyder","sequence":"additional","affiliation":[{"name":"University of Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Princip","sequence":"additional","affiliation":[{"name":"Department of Consultation\u2010Liaison Psychiatry and Psychosomatic Medicine University Hospital ZurichUniversity of Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aju P.","family":"Pazhenkottil","sequence":"additional","affiliation":[{"name":"Department of Consultation\u2010Liaison Psychiatry and Psychosomatic Medicine University Hospital ZurichUniversity of Zurich Switzerland"},{"name":"Department of Cardiology University Hospital ZurichUniversity of Zurich Switzerland"},{"name":"Cardiac Imaging Department of Nuclear Medicine University Hospital ZurichUniversity of Zurich 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