Antipsychotic exposure prior to acute myocardial infarction in patients with serious mental illness. (14th October 2014)

• Record Type: Journal Article
• Authors: Wu, S.‐I.; Kao, K.‐L.; Chen, S.‐C.; Juang, J. J. M.; Lin, C.‐J.; Fang, C.‐K.; Wu, C.‐S.; Dewey, M.; Prince, M. J.; Stewart, R.
• Is Part Of: Acta psychiatrica Scandinavica. Volume 131:Number 3(2015:Mar.)
• Page Start: 213
• Page End: 222
• Publication Date: 2014-10-14
• Subjects: Psychiatry -- Periodicals; 616.89
• DOI: 10.1111/acps.12345
• Languages: English
• ISSNs: 0001-690X

Abstract

<abstract abstract-type="main" id="acps12345-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="acps12345-sec-0001" sec-type="section"> <title>Objective</title> <p>To investigate the association between acute myocardial infarction (AMI) and recent exposure to antipsychotic agents in people with serious mental illness (SMI), and modifying influences.</p> </sec> <sec id="acps12345-sec-0002" sec-type="section"> <title>Method</title> <p>A case‐crossover design was applied using the Taiwan National Health Insurance Research Database (NHIRD) to compare the exposure frequency of antipsychotic agents within individuals of schizophrenia or bipolar disorder between 60‐day case and control periods prior to their first AMI episode during 1996–2007.</p> </sec> <sec id="acps12345-sec-0003" sec-type="section"> <title>Results</title> <p>A sample of 834 patients with incident AMI was analysed. AMI was significantly associated with more recent antipsychotic exposure in schizophrenia after adjustment (OR 1.87, 95% confidence interval 1.15–3.03) bipolar disorder (OR 1.06, 0.51–2.21). This association in schizophrenia was significantly stronger in men and in patients without previous diagnoses of cardiovascular risk factors.</p> </sec> <sec id="acps12345-sec-0004" sec-type="section"> <title>Conclusion</title> <p>These findings are consistent with a short‐term risk effect of antipsychotic exposure on risk of AMI and identify potentially vulnerable groups. Further research is required to clarify underlying biological mechanisms.</p> </sec> </abstract>