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

doi:10.1111/acps.12345

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 journal › Article › peer-review

16 Citations (Scopus)

Abstract

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 language	English
Pages (from-to)	213-222
Number of pages	10
Journal	Acta Psychiatrica Scandinavica
Volume	131
Issue number	3
DOIs	https://doi.org/10.1111/acps.12345
Publication status	Published - 1 Mar 2015

Keywords

Acute myocardial infarction
Antipsychotic
Bipolar disorder
Schizophrenia
Serious mental illness

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title = "Antipsychotic exposure prior to acute myocardial infarction in patients with serious mental illness",

abstract = "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.",

keywords = "Acute myocardial infarction, Antipsychotic, Bipolar disorder, Schizophrenia, Serious mental illness",

author = "Wu, {S. I.} and Kao, {K. L.} and Chen, {S. C.} and Juang, {J. J M} and Lin, {C. J.} and Fang, {C. K.} and Wu, {C. S.} and M. Dewey and Prince, {M. J.} and R. Stewart",

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doi = "10.1111/acps.12345",

language = "English",

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AU - Wu, S. I.

AU - Kao, K. L.

AU - Chen, S. C.

AU - Juang, J. J M

AU - Lin, C. J.

AU - Fang, C. K.

AU - Wu, C. S.

AU - Dewey, M.

AU - Prince, M. J.

AU - Stewart, R.

PY - 2015/3/1

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N2 - 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.

AB - 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.

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

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Keywords

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