Abstract 12314: The Long-Term Effect of Coronary Atherosclerosis and Apnea Hypopnea Index During Rapid Eye Movement on Posttraumatic Stress Disorder

Introduction: Posttraumatic-stress-disorder(PTSD) is associated with subclinical-atherosclerosis as well as rapid-eye-movement(REM) apnea-hypopnea-index(AHI). This study investigated the relation of coronary-atherosclerosis measured by coronary-artery-calcium(CAC), REM-AHI with cardiovascular(CV)-mortality in PTSD. Hypothesis: There is a direct relation between CAC and REM-AHI with increased CV-mortality in PTSD. Methods: This study is consist of 634 veterans without-known-CAD(age:58±11years,86%men) underwent CAC-scanning and overnight poly-somnography for clinical-indications. Psychological-health-status(PTSD vs. non-PTSD)was measured and they were followed for median of 36-months. Multivariable-Cox-regression-analyses were employed to assess the relation of REM-AHI and CAC, with CV-mortality in PTSD. Results: At follow-up (figure 1), the death-rate was higher in the PTSD(17%) than non-PTSD(10.4%)(p=0.001). Regression-analyses revealed a significant-linkage between PTSD and CAC as well as PTSD and REM-AHI with CV-mortality. The relative-risk of CV-mortality was 5.72(95%CI:2.46-13.34,p=0.0001) in PTSD and CAC>0 as compared to non-PTSD with CAC=0. Similarly, the relative risk of CV-mortality was 3.22 (95%CI:1.17-8.85, p=0.02) in PTSD and REM AHI≥30 as compared to non-PTSD with REM AHI0 which was more prominent in PTSD(p=0.001). A significant linkage of CAC and REM-AHI with increased CV-mortality in PTSD was noted in which the relative-risk of CV-mortality in PTSD was 6.44 (95%CI:3.64-11.37,p=0.001) in combined CAC>0 and REM AHI≥30 as compared to non-PTSD. Conclusions: 1)PTSD is associated with the coronary-atherosclerosis and increased CV-mortality, 2)PTSD is associated with REM obstructive-sleep-apnea and predicts CV-mortality and 3) There is an independent significant linkage of PTSD with REM obstructive-sleep-apnea as well as coronary-atherosclerosis, and increased risk of CV-mortality.