Electrocardiogram Characteristics and Their Association With Psychotropic Drugs Among Patients With Schizophrenia.

Autor:	Polcwiartek C; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.; Division of Cardiology, Duke University Medical Center, Durham, NC.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.; Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark., Kragholm K; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.; Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark.; Department of Cardiology, North Denmark Regional Hospital, Hjørring, Denmark., Hansen SM; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark., Atwater BD; Division of Cardiology, Duke University Medical Center, Durham, NC., Friedman DJ; Division of Cardiology, Duke University Medical Center, Durham, NC., Barcella CA; Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Copenhagen, Denmark., Graff C; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark., Nielsen JB; Laboratory for Molecular Cardiology, Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark., Pietersen A; Copenhagen General Practitioners' Laboratory, Copenhagen, Denmark., Nielsen J; Mental Health Center Glostrup, Copenhagen University Hospital Glostrup, Copenhagen, Denmark., Søgaard P; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Torp-Pedersen C; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.; Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Aalborg, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.; Department of Health Science and Technology, Aalborg University, Aalborg, Denmark., Jensen SE; Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
Jazyk:	angličtina
Zdroj:	Schizophrenia bulletin [Schizophr Bull] 2020 Feb 26; Vol. 46 (2), pp. 354-362.
DOI:	10.1093/schbul/sbz064
Abstrakt:	Background: There are limited data on electrocardiogram (ECG) characteristics and their association with psychotropic drugs in schizophrenia. Methods: Using a cross-sectional design, we included Danish primary care patients with first-time digital ECGs from 2001 to 2015. Patients diagnosed with schizophrenia before ECG recording were matched 1:5 on age, sex, and ECG recording year to controls without psychiatric disease. Multivariable logistic regression was used to compute odds ratios (ORs) with 95% confidence intervals (CIs). Results: We included 4486 patients with schizophrenia matched with 22 430 controls (median age, 47 years; male, 55%). Between groups, the prevalence of abnormal ECGs was similar (54%, P = .536), but patients with schizophrenia demonstrated higher median heart rate (79 vs 69 beats per minute, P < .001) and Fridericia-corrected QT (QTc) interval (416 vs 412 ms, P < .001) than controls. QTc prolongation was also more prevalent among patients with schizophrenia (3.4% vs 1.1%, P < .001), and so were pathological Q waves (5.3% vs 3.9%, P < .001). Patients with schizophrenia less frequently demonstrated left ventricular hypertrophy (6.1% vs 9.6%, P < .001) and atrial fibrillation or flutter (0.7% vs 1.4%, P < .001). Among patients with schizophrenia only, particularly antipsychotics were associated with abnormal ECGs (OR, 1.20; 95% CI, 1.04-1.39). Conclusions: Patients with schizophrenia demonstrate a different cardiovascular risk profile than matched controls without psychiatric disease, with higher prevalence of elevated heart rate, QTc prolongation, and pathological Q waves, and lower prevalence of left ventricular hypertrophy and atrial fibrillation or flutter. Particularly antipsychotics were associated with abnormal ECGs. This underscores an integrated care approach when ECG abnormalities are detected in this group. (© The Author(s) 2019. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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