Antipsychotic exposure prior to acute myocardial infarction in patients with serious mental illness

S. I. Wu, K. L. Kao, S. C. Chen, J. J M Juang, C. J. Lin, C. K. Fang, C. S. Wu*, M. Dewey, M. J. Prince, R. Stewart

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


Objective: 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. Method: 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. Results: 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)213-222
Number of pages10
JournalActa Psychiatrica Scandinavica
Issue number3
Publication statusPublished - 1 Mar 2015


  • Acute myocardial infarction
  • Antipsychotic
  • Bipolar disorder
  • Schizophrenia
  • Serious mental illness


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