A comparison of ten-year cardiac risk estimates in schizophrenia patients from the CATIE study and matched controls
A comparison of ten-year cardiac risk estimates in schizophrenia patients from the CATIE study and matched controls
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DOI：
10.1016/j.schres.2005.08.010
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发表时间：
2005-12-01
影响因子：
4.5
通讯作者：
Lieberman, JA
中科院分区：
文献类型：
--
作者：
Goff, DC;Sullivan, LM;Lieberman, JA
目的：与普通人群相比，精神分裂症患者的标化死亡率较高。尽管最近人们对某些非典型抗精神病药物的代谢并发症感到担忧，但冠心病的发病率以及冠心病对精神分裂症患者死亡率增加的相对贡献尚不清楚。方法：使用Framingham CHD风险函数计算689名参加抗精神病药物治疗有效性临床试验(CATIE)精神分裂症试验的受试者的10年冠心病风险，并与年龄、结果：男性(9.4%比7.0%)和女性(6.3%比4.2%)精神分裂症患者的10年冠心病风险显著高于对照组(p=0.0001)。与对照组(p<；0.001)相比，精神分裂症患者的吸烟率(69%比35%)、糖尿病(13%比3%)和高血压(27%比17%)的发病率要高得多，高密度脂蛋白胆固醇水平(43.7mgdl比49.3mgdl)要低得多。只有总胆固醇水平在不同组之间没有差异。在控制体重指数后，精神分裂症患者的10年冠心病风险仍然显著增加(p=0.0001)。结论：这些结果与最近精神分裂症患者心脏死亡率增加的证据一致。虽然吸烟的影响是明确的，但特定的抗精神病药物、饮食、锻炼和医疗质量对心脏风险的相对贡献仍有待澄清。(C)2005 Elsevier B.V.保留所有权利。
Objective: Standardized mortality rates are elevated in schizophrenia compared to the general population. The incidence of coronary heart disease (CHD) and the relative contribution of CHD to increased mortality in schizophrenia patients are not clear, despite recent concerns about metabolic complications of certain atypical antipsychotics.Method: Ten-year risk for CHD was calculated for 689 subjects who participated in the Clinical Trials of Antipsychotic Treatment Effectiveness (CATIE) Schizophrenia Trial at baseline using the Framingham CHD risk function and were compared with age-, race- and gender-matched controls from the National Health and Nutrition Examination Survey (NHANES) III.Results: Ten-year CHD risk was significantly elevated in male (9.4% vs. 7.0%) and female (6.3% vs. 4.2%) schizophrenia patients compared to controls (p=0.0001). Schizophrenia patients had significantly higher rates of smoking (69% vs. 35%), diabetes (13% vs. 3%), and hypertension (27% vs. 17%) and lower HDL cholesterol levels (43.7 vs. 49.3 mg/dl) compared to controls (p < 0.001). Only total cholesterol levels did not differ between groups. Ten-year CHD risk remained significantly elevated in schizophrenia patients after controlling for body mass index (p = 0.0001).Conclusions: These results are consistent with recent evidence of increased cardiac mortality in schizophrenia patients. While the impact of cigarette smoking is clear, the relative contributions to cardiac risk of specific antipsychotic agents, diet, exercise, and quality of medical care remain to be clarified. (c) 2005 Elsevier B.V. All rights reserved.