Weeke P, Jensen A, Folke F, Gislason G H, Olesen J B, Fosbøl E L, Wissenberg M, Lippert F K, Christensen E F, Nielsen S L, Holm E, Kanters J K, Poulsen H E, Køber L, Torp-Pedersen C
Department of Cardiology, Copenhagen University Hospital, Gentofte, Denmark.
Department of Biostatistics, University of Copenhagen, Copenhagen, Denmark.
Clin Pharmacol Ther. 2014 Oct;96(4):490-7. doi: 10.1038/clpt.2014.139. Epub 2014 Jun 24.
Antipsychotic drugs have been associated with sudden cardiac death, but differences in the risk of out-of-hospital cardiac arrest (OHCA) associated with different antipsychotic drug classes are not clear. We identified all OHCAs in Denmark (2001-2010). The risk of OHCA associated with antipsychotic drug use was evaluated by conditional logistic regression analysis in case-time-control models. In total, 2,205 (7.6%) of 28,947 OHCA patients received treatment with an antipsychotic drug at the time of the event. Overall, treatment with any antipsychotic drug was associated with OHCA (odds ratio (OR) = 1.53, 95% confidence interval (CI): 1.23-1.89), as was use with typical antipsychotics (OR = 1.66, CI: 1.27-2.17). By contrast, overall, atypical antipsychotic drug use was not (OR = 1.29, CI: 0.90-1.85). Two individual typical antipsychotic drugs, haloperidol (OR = 2.43, CI: 1.20-4.93) and levomepromazine (OR = 2.05, CI: 1.18-3.56), were associated with OHCA, as was one atypical antipsychotic drug, quetiapine (OR = 3.64, CI: 1.59-8.30).
抗精神病药物与心源性猝死有关，但不同类别的抗精神病药物与院外心脏骤停（OHCA）风险之间的差异尚不清楚。我们确定了丹麦所有的院外心脏骤停病例（2001年至2010年）。在病例-时间-对照模型中，通过条件逻辑回归分析评估了使用抗精神病药物与院外心脏骤停风险之间的关系。在28947例院外心脏骤停患者中，共有2205例（7.6%）在事件发生时接受了抗精神病药物治疗。总体而言，使用任何抗精神病药物都与院外心脏骤停有关（比值比（OR）=1.53，95%置信区间（CI）：1.23-1.89），使用典型抗精神病药物也是如此（OR=1.66，CI：1.27-2.17）。相比之下，总体而言，使用非典型抗精神病药物则不然（OR=1.29，CI：0.90-1.85）。两种个别典型抗精神病药物，氟哌啶醇（OR=2.43，CI：1.20-4.93）和左美丙嗪（OR=2.05，CI：1.18-3.56）与院外心脏骤停有关，一种非典型抗精神病药物喹硫平也是如此（OR=3.64，CI：1.59-8.30）。
