{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:04:13Z","timestamp":1790298253660,"version":"4.1.0"},"reference-count":59,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,9,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">There is increasing recognition that trauma exposure and related psychiatric consequences predict cardiovascular disease risk. However, most research has specifically examined post\u2010traumatic stress disorder\u2014despite evidence that a range of psychiatric disorders may follow trauma. We applied machine learning to identify key post\u2010traumatic psychiatric predictors of incident major adverse cardiac and cerebrovascular events (MACCE) in a population\u2010based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We conducted a case\u2013control study of adults aged \u226518\u2009years, nested within a trauma\u2010exposed cohort of all Denmark residents from 1995 to 2018. Cases (\n                      <jats:italic toggle=\"no\">n<\/jats:italic>\n                      =43\u2009994) experienced MACCE (non\u2010fatal myocardial infarction, non\u2010fatal stroke, coronary revascularization, cardiovascular death) between 1995 and 2019. Controls (\n                      <jats:italic toggle=\"no\">n<\/jats:italic>\n                      =175\u2009872) were matched 4:1 on MACCE date, sex, year of trauma, and age at trauma. Machine learning model predictors included a range of psychiatric disorders diagnosed \u22643\u2009years following trauma. Sex\u2010stratified machine learning models were trained using extreme gradient boosting (men:\n                      <jats:italic toggle=\"no\">n<\/jats:italic>\n                      =91\u2009111; women:\n                      <jats:italic toggle=\"no\">n<\/jats:italic>\n                      =84\u2009781) and tested in hold\u2010out datasets (men:\n                      <jats:italic toggle=\"no\">n<\/jats:italic>\n                      =22\u2009777; women:\n                      <jats:italic toggle=\"no\">n<\/jats:italic>\n                      =21\u2009197). We identified the 15 most important psychiatric disorder predictors of MACCE using Shapley Additive Explanations values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">For men and women, the most important psychiatric predictor of MACCE was alcohol use disorders. Other important psychiatric predictors included depressive disorders, post\u2010traumatic stress disorder\/stress\u2010related disorders, brain\u2010related\/physiological conditions, and non\u2010substance\u2010induced delirium. Some sex\u2010specific findings also emerged (eg, depressive episodes more important for women than men). Overall, odds ratios in training and testing sets indicated that odds of MACCE were greater among those with (versus without) psychiatric disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Results emphasize the importance of considering a range of psychiatric disorders when assessing cardiovascular risk following trauma.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.126.049492","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:50:30Z","timestamp":1788353430000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Post\u2010traumatic Psychopathology and Cardiovascular Risk: A Danish Case\u2013Control Study of Sex\u2010Specific Associations"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0217-7171","authenticated-orcid":false,"given":"Jennifer A.","family":"Sumner","sequence":"first","affiliation":[{"name":"University of California, Los Angeles","place":["Los Angeles, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8385-8621","authenticated-orcid":false,"given":"Anthony J.","family":"Rosellini","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7831-999X","authenticated-orcid":false,"given":"P\u00e9ter","family":"Szentk\u00fati","sequence":"additional","affiliation":[{"name":"Aarhus University Hospital and Aarhus University","place":["Aarhus, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-2212","authenticated-orcid":false,"given":"Erzs\u00e9bet","family":"Horv\u00e1th\u2010Puh\u00f3","sequence":"additional","affiliation":[{"name":"Aarhus University Hospital and Aarhus University","place":["Aarhus, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6358-8962","authenticated-orcid":false,"given":"Hans Erik","family":"B\u00f8tker","sequence":"additional","affiliation":[{"name":"Aarhus University Hospital and Aarhus University","place":["Aarhus, Denmark"]},{"name":"Aarhus University Hospital and Aarhus University","place":["Aarhus, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L.","family":"Lash","sequence":"additional","affiliation":[{"name":"Emory University","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6195-716X","authenticated-orcid":false,"given":"Paula P.","family":"Schnurr","sequence":"additional","affiliation":[{"name":"National Center for PTSD Executive Division","place":["White River Junction, USA"]},{"name":"Geisel School of Medicine at Dartmouth","place":["Hanover, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7534-0945","authenticated-orcid":false,"given":"Sandro","family":"Galea","sequence":"additional","affiliation":[{"name":"Washington University School of Public Health","place":["Saint Louis, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-7040","authenticated-orcid":false,"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health","place":["Boston, USA"]},{"name":"Aarhus University Hospital and Aarhus University","place":["Aarhus, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1459-5327","authenticated-orcid":false,"given":"Jaimie L.","family":"Gradus","sequence":"additional","affiliation":[{"name":"Boston University School of Public Health","place":["Boston, USA"]},{"name":"Aarhus University Hospital and Aarhus University","place":["Aarhus, Denmark"]},{"name":"Boston University School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291715001981"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-023-02330-8"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jts.22777"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080573"},{"key":"e_1_3_1_6_2","first-page":"502","volume-title":"Handbook of PTSD: Science and Practice","author":"Schnurr PP","year":"2014","unstructured":"Schnurr PP, Wachen JS, Green BL, Kaltman S. 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