Individuals with adverse childhood experience may be at greater risk for major adverse cardiovascular events (MACE) as a result of impaired coronary distensibility index, according to research presented at the American Psychiatric Association (APA) 2017 Annual Meeting, held May 20-24, in San Diego, California.
As the study investigators explained, impaired coronary distensibility index is a marker of vascular dysfunction and can predict MACE. A total of 246 participants (aged 18-70 years; 31% women) underwent computed tomography angiography for clinical indication of impaired coronary distensibility index and were followed up for a mean of 60 months.
Adverse childhood experiences were measured using the Childhood Trauma Questionnaire and Dimensions of Stressful Events Rating Scale. Of the total study population, 79 participants had adverse childhood experience and 167 participants did not.
The researchers found a significant inverse correlation between coronary distensibility index and Clinical Global Impression Scale of adverse childhood experience symptoms (r2=0.61; P =.001). In participants with adverse childhood experiences, the coronary distensibility index was considerably lower (3.1±0.2 vs 4.6±0.2; P =.001), and regression analysis demonstrated that adverse childhood experiences and impaired coronary distensibility index are significantly associated with increased MACE.
In addition, the risk for MACE decreased when patients who had adverse childhood experiences did not have impaired coronary distensibility index vs patients who had both adverse childhood experiences and impaired coronary distensibility index (P <.01).
“This highlights the important role of [coronary distensibility index] in identifying individuals with [adverse childhood experience] at risk for MACE,” the researchers concluded.
Several study limitations were noted; particularly, that it was a single-center analysis and that only 2 scales were used for assessing adverse childhood experiences because of the lack of availability of other standardized measurements for this population.
Ahmadi N, Pynoos R, Hajsadeghi F, Hauser P, Olango G, Molla M. Adverse childhood experience is associated with impaired coronary distensibility index and predicts major adverse cardiovascular events. Presented at: American Psychiatric Association (APA) 2017 Annual Meeting; May 20-24, 2017; San Diego, CA. Abstract No. P5-56