Understanding Traumatic Stress Following Myocardial Infarction: A Systematic Review

Abstract

More than one million Australians have some form of heart disease, with around half of those experiencing a myocardial infarction (MI) during their lifetime. The purpose of this systematic review is to summarise the literature on traumatic stress post-MI. This study aims to identify the different ways in which traumatic stress symptomatology is assessed and classified post-MI, and the implications this has for translation from research to policy and practice. A comprehensive search protocol, developed in collaboration with clinicians and a research librarian, was applied to six databases. This resulted in 3273 records identified for screening. The online tool Covidence was used for managing the study selection process, using predefined inclusion/exclusion criteria. A second reviewer independently screened a subset of the studies to assess the reliability of the inclusion/exclusion criteria. Following removal of duplicate records and further screening, 13 studies were identified and included in the review. Results suggest there is increasing evidence for the occurrence of traumatic stress post-MI. Detection of this condition is influenced by methodological differences, with clinical interviews measures identifying lower figures than self-report. Post-MI traumatic stress symptomatology presents atypical characteristics and chronicity, which poses important consequences for researchers, practitioners, and patients. While MI mortality rates are falling steadily, the increase in the number of survivors with traumatic stress requires timely translation of research to policy and practice, to promote the ongoing wellbeing of this patient group.