{"doi":"10.1001/jamacardio.2020.5749","title":"Association of Early-Life Trauma and Risk of Adverse Cardiovascular Outcomes in Young and Middle-aged Individuals With a History of Myocardial Infarction","abstract":"Importance: Compared with older patients, young adults with a history of myocardial infarction (MI) tend to have a higher burden of psychosocial adversity. Exposure to early-life stressors may contribute to the risk of adverse outcomes in this patient population, potentially through inflammatory pathways. Objective: To investigate the association of early-life trauma with adverse events and examine whether inflammation plays a role. Design, Setting, and Participants: This cohort study included patients aged 18 to 60 years with a verified history of MI in the past 8 months from a university-affiliated hospital network. Baseline data were collected from June 2011 to March 2016, and follow-up data were obtained through July 2019. Analysis began September 2019. Exposures: Early-life trauma was assessed using the Early Trauma Inventory-Self Report short form (ETI-SR-SF), both as a continuous and as a binary variable at the threshold of a score of 7 or higher. Inflammatory biomarkers, interleukin 6, and C-reactive protein were obtained at baseline. Main Outcomes and Measures: A composite end point of recurrent MI, stroke, heart failure hospitalization, and cardiovascular death over a median 3-year follow-up. Results: Of 300 patients, the mean (SD) age was 51 (7) years, 198 (66%) were African American, and 150 (50%) were women. Compared with participants with MI with an ETI-SR-SF score less than 7, those with a score of 7 or higher had higher levels of interleukin 6 and C-reactive protein at baseline. Compared with participants with an ETI-SR-SF score less than 7, those with a score of 7 or higher were at a greater risk for adverse outcomes, with a hazards ratio of 2.3 (95% CI, 1.3-3.9). Results remained consistent in multivariable analysis. Further adjustment for C-reactive protein rendered the results no longer statistically significant. Early-life trauma displayed a dose-dependent response when analyzed as a continuous variable and by quartiles. Conclusions and Relevance: Early-life trauma is an independent risk factor for adverse outcomes in young and middle-aged individuals with a history of MI. Neurobiological mechanisms leading to lifetime activation of systemic inflammatory cascades may be implicated.","journal":"JAMA Cardiology","year":2020,"id":69419,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.963,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":304830,"name":"Matthew T. Wittbrodt","orcid":"0000-0002-9533-8041","position":1,"is_corresponding":false},{"id":330184,"name":"An Young","orcid":null,"position":2,"is_corresponding":false},{"id":328665,"name":"Bruno B. Lima","orcid":"0000-0001-5540-932X","position":3,"is_corresponding":false},{"id":328664,"name":"Muhammad Hammadah","orcid":"0000-0002-1596-4836","position":4,"is_corresponding":false},{"id":368270,"name":"Mariana García","orcid":null,"position":5,"is_corresponding":false},{"id":366009,"name":"Lisa Elon","orcid":"0000-0003-2307-6617","position":6,"is_corresponding":false},{"id":306442,"name":"Bradley D. Pearce","orcid":null,"position":7,"is_corresponding":false},{"id":338684,"name":"Yingtian Hu","orcid":"0000-0003-4171-8716","position":8,"is_corresponding":false},{"id":328663,"name":"Samaah Sullivan","orcid":"0000-0001-9427-7235","position":9,"is_corresponding":false},{"id":328672,"name":"Puja K. Mehta","orcid":"0000-0002-5678-812X","position":10,"is_corresponding":false},{"id":304833,"name":"Emily Driggers","orcid":"0000-0002-4142-3347","position":11,"is_corresponding":false},{"id":367565,"name":"Ye Ji Kim","orcid":"0000-0003-1583-1408","position":12,"is_corresponding":false},{"id":98920,"name":"Tené T. Lewis","orcid":null,"position":13,"is_corresponding":false},{"id":325857,"name":"Shakira F. Suglia","orcid":"0000-0002-5634-9290","position":14,"is_corresponding":false},{"id":304839,"name":"Amit Shah","orcid":"0000-0001-9099-9687","position":15,"is_corresponding":false},{"id":266102,"name":"J. Douglas Bremner","orcid":"0000-0003-1633-6433","position":16,"is_corresponding":false},{"id":236696,"name":"Arshed A. Quyyumi","orcid":"0000-0002-8166-679X","position":17,"is_corresponding":false},{"id":292487,"name":"Viola Vaccarino","orcid":"0000-0002-9054-0654","position":18,"is_corresponding":false},{"id":311866,"name":"Zakaria Almuwaqqat","orcid":"0000-0001-6606-1031","position":0,"is_corresponding":true}],"reference_count":17,"raw_metadata":null,"created_at":"2026-07-18T21:42:22.705573Z","pmid":"33185652","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}