Haddad Chadia, Hallit Souheil, Salameh Pascale, Bou-Assi Tarek, Zoghbi Marouan
Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
Equal contribution.
J Comorb. 2017 Jul 13;7(1):79-88. doi: 10.15256/joc.2017.7.107. eCollection 2017.
Coronary heart disease (CHD) is a leading cause of premature death in patients with schizophrenia. CHD risk in Lebanese patients with schizophrenia remains unknown.
To (i) evaluate CHD risk of patients with schizophrenia in Lebanon; and (ii) detect the modifiable and non-modifiable factors affecting this risk.
Cross-sectional study of 329 patients with schizophrenia aged 20-75 years. Ten-year hard CHD risk was calculated using the Framingham risk score. A logistic regression was conducted taking the dichotomous hard CHD (<10% and ≥10%) as the dependent variable.
Ten-year hard CHD risk was low (<10%) in 60.8% of patients, intermediate (10-20%) in 31.6%, and high (>20%) in 7.6%. Multivariate analysis showed that the mean 10-year hard CHD risk was 8.76±6.92 (10.82±6.83 in men and 3.18±2.90 in women). Ten-year hard CHD risk was higher in patients with the metabolic syndrome (odds ratio [OR] 2.67, confidence interval [CI] 1.54-4.64), a longer duration of schizophrenia (OR 1.03, CI 1.01-1.05), a history of other medical illnesses (OR 2.02, CI 1.18-3.47), and in those participating in art therapy (OR 2.13, CI 1.25-3.64) or therapeutic education (OR 1.93, CI 0.93-4.01). Ten-year hard CHD risk was lower in patients receiving risperidone (OR 0.23, CI 0.08-0.68), any anti-epileptic (OR 0.41, CI 0.24-0.73), or any benzodiazepine (OR 0.33, CI 0.17-0.66) medication.
CHD is prevalent in patients with schizophrenia in Lebanon. Physicians are recommended to monitor the components of the metabolic syndrome to identify patients with increased risk of cardiovascular diseases.
冠心病（CHD）是精神分裂症患者过早死亡的主要原因。黎巴嫩精神分裂症患者的冠心病风险尚不清楚。
（i）评估黎巴嫩精神分裂症患者的冠心病风险；（ii）检测影响该风险的可改变和不可改变因素。
对329名年龄在20至75岁之间的精神分裂症患者进行横断面研究。使用弗雷明汉风险评分计算10年的严重冠心病风险。以二分法的严重冠心病（<10%和≥10%）作为因变量进行逻辑回归分析。
60.8%的患者10年严重冠心病风险较低（<10%），31.6%的患者为中等风险（10 - 20%），7.6%的患者为高风险（>20%）。多变量分析显示，10年严重冠心病的平均风险为8.76±6.92（男性为10.82±6.83，女性为3.18±2.90）。代谢综合征患者的10年严重冠心病风险更高（比值比[OR]为2.67，置信区间[CI]为1.54 - 4.64），精神分裂症病程较长者（OR为1.03，CI为1.01 - 1.05），有其他内科疾病史者（OR为2.02，CI为1.18 - 3.47），以及参加艺术治疗者（OR为2.13，CI为1.25 - 3.64）或接受治疗性教育者（OR为1.93，CI为0.93 - 4.01）。接受利培酮治疗的患者（OR为0.23，CI为0.08 - 0.68）、服用任何抗癫痫药物的患者（OR为0.41，CI为0.24 - 0.73）或服用任何苯二氮䓬类药物的患者（OR为0.33，CI为0.17 - 0.66）的10年严重冠心病风险较低。
冠心病在黎巴嫩精神分裂症患者中普遍存在。建议医生监测代谢综合征的各项指标，以识别心血管疾病风险增加的患者。
