Nakagawa S, Pedersen L, Olsen M L, Mortensen P B, Sørensen H T, Johnsen S P
National Centre for Register-Based Research, University of Aarhus, Aarhus, Denmark.
J Intern Med. 2006 Nov;260(5):451-8. doi: 10.1111/j.1365-2796.2006.01708.x.
Use of antipsychotics has been linked with an adverse cardiovascular risk factor profile and an increased risk of dysrhythmia and sudden cardiac death. However, detailed data on the association between use of antipsychotics and development of atherosclerotic disease are limited.
To examine risk of hospitalization for myocardial infarction (MI) amongst users of antipsychotics compared with non-users.
A population-based case-control study using data from hospital discharge registries in the counties of North Jutland, Viborg and Aarhus, Denmark, and the Danish Civil Registration System. We identified 21,377 cases of first-time hospitalization for MI and 106,885 sex- and age-matched non-MI population controls in the period 1992-2004. All prescriptions for antipsychotics filled prior to the date of admission for MI were retrieved from population-based prescription databases. We used conditional logistic regression to adjust for a wide range of covariates.
Current users of atypical [adjusted relative risk: 0.98, 95% confidence interval (CI): 0.88-1.09] and typical antipsychotics (adjusted relative risk: 0.99, 95% CI: 0.96-1.03) had no increased overall risk of being admitted to hospital for MI when compared with non-users of antipsychotics. These findings were consistent in all examined subgroups. Further, we found no association between the cumulative dose of antipsychotics and the risk of hospitalization for MI.
These findings do not support the hypothesis that use of antipsychotics and in particular atypical antipsychotics is associated with increased risk of MI.
使用抗精神病药物与不良心血管危险因素谱以及心律失常和心源性猝死风险增加有关。然而，关于抗精神病药物使用与动脉粥样硬化疾病发生之间关联的详细数据有限。
研究与未使用抗精神病药物者相比，使用抗精神病药物者发生心肌梗死（MI）住院的风险。
一项基于人群的病例对照研究，使用丹麦北日德兰郡、维堡郡和奥胡斯郡医院出院登记处的数据以及丹麦民事登记系统的数据。我们在1992年至2004年期间确定了21377例首次因MI住院的病例以及106885名性别和年龄匹配的非MI人群对照。从基于人群的处方数据库中检索出MI入院日期之前开具的所有抗精神病药物处方。我们使用条件逻辑回归来调整一系列协变量。
与未使用抗精神病药物者相比，当前使用非典型抗精神病药物者（调整后的相对风险：0.98，95%置信区间（CI）：0.88 - 1.09）和典型抗精神病药物者（调整后的相对风险：0.99，95% CI：0.96 - 1.03）因MI住院的总体风险没有增加。这些发现在所有检查的亚组中都是一致的。此外，我们没有发现抗精神病药物的累积剂量与因MI住院风险之间存在关联。
这些发现不支持使用抗精神病药物，尤其是非典型抗精神病药物与MI风险增加相关的假设。
