Serious cardiovascular events and mortality among patients with schizophrenia
Serious cardiovascular events and mortality among patients with schizophrenia
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DOI：
10.1097/01.nmd.0000105996.62105.07
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发表时间：
2004-01-01
影响因子：
1.9
通讯作者：
Walker, AM
中科院分区：
文献类型：
--
作者：
Enger, C;Weatherby, L;Walker, AM
这项研究比较了精神分裂症患者的心血管发病率和死亡率的风险，他们在大型托管护理组织中使用抗精神病药物的风险与没有精神分裂症的人的风险。根据年龄，性别，日期和健康计划，将1,920名精神分裂症患者的样本与从健康计划一般会员资格中随机选择的9600人相匹配。使用国家死亡指数搜索和医疗索赔记录确定死亡，心肌梗塞，心律不齐和新发育糖尿病。经过治疗的精神分裂症患者组的调整后全因死亡率是对照组的四倍，无论对照组是否比对照组高四倍。给予患者典型或非典型抗精神病药物。典型抗精神病药的使用者的心肌梗塞风险高五倍。在精神分裂症患者中，心血管风险与抗精神病药的使用强度成反比，这表明观察到的风险可能不是由于药物的简单或直接作用。接受精神分裂症治疗的患者的新发糖尿病患者比一般人群对照更高。这种风险最为明显，在暴露于药物的人中，似乎在典型的抗精神病药，非典型产品或两者的使用者中似乎是无法区分的。
This study compared the risks of cardiovascular morbidity and mortality in people with schizophrenia who use antipsychotic medications to risks in individuals without schizophrenia in a large managed care organization. A sample of 1,920 schizophrenia patients was matched by age, sex, date, and health plan to 9,600 persons randomly selected from the health plan general membership. Death, myocardial infarction, arrhythmia, and new-onset diabetes were identified using a National Death Index search and medical claims records.The adjusted all-cause mortality rate in the group of treated schizophrenics was four times higher than in the control group regardless of whether patients were given a typical or an atypical antipsychotic medication. Users of typical antipsychotics had a fivefold higher risk of myocardial infarction than the control subjects. Among patients with schizophrenia, cardiovascular risk was inversely associated with intensity of use of antipsychotic drugs, suggesting that the observed risks may not be due to a simple or direct effect of drugs. Patients treated for schizophrenia had higher rates of new-onset diabetes than did the general population controls. This risk was most pronounced in persons with more intense exposure to drugs and appeared to be indistinguishable in users of typical antipsychotics, of atypical products, or of both.