Past Issues

Excess Mortality, Risk of Acute Myocardial Infarction, and Related Medical Care Receipts in People with Serious Mental Illness

Shu-I Wu, Vincent Chin-Hung Chen, Robert Stewart

People with serious mental illness (SMI, including schizophrenia and bipolar disorder) experience adverse health and premature mortality. Higher incidence or worse outcomes of acute myocardial infarction (AMI), and antipsychotic exposures, may partly underlie this. In this overview, we are exploring whether the relative risk of AMI in people with SMI are higher than general population. Intervention receipts of invasive cardiac care and inpatient mortality between people with or without SMI are compared. Possible associations between the risk of AMI and use of antipsychotic agents are elaborated. We summarize (A) overall, no increased risk of AMI has been found in people with SMI, apart from in sub-group analyses (suggesting an excess SMI-associated risk in younger women); (B) Patients with schizophrenia and bipolar disorder are less than half as likely to receive invasive coronary interventions following AMI episode compared to controls; (C) Inpatient mortality was higher in patients with schizophrenia compared to controls. Potential public health, clinical, and research implications are also discussed at the end of this overview.
Key Word schizophrenia, bipolar disorder, risk, acute myocardial infarction
Editorial Committe, Taiwanese Journal of Psychiatry
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