确定诊断为精神分裂症和双相情感障碍患者的心血管疾病风险。
DETERMINING THE RISK OF CARDIOVASCULAR DISEASE IN PATIENTS DIAGNOSED WITH SCHIZOPHRENIA AND BIPOLAR AFFECTIVE DISORDER.
机构信息
Sağlık Bilimleri University, Faculty of Medicine, Department of Psychiatry, Erenkoy mental and nervous diseases training and research hospital, Istanbul, Turkiye.
Kosuyolu High Specialization Training and Research Hospital, Department of Cardiology, Istanbul, Turkiye.
出版信息
Psychiatr Danub. 2023 Summer;35(2):187-198. doi: 10.24869/psyd.2023.187.
BACKGROUND
In Schizophrenia (SCZ) and Bipolar Affective Disorder (BAD) patients using the Framingham Heart Risk Scoring (FHRS), we aimed to investigate the possible cardiac arrhythmia risk by calculating electrocardiogram (ECG) parameters (QT, QTc, Tpe, and TPE/QTc ratios), which are ventricular repolarization markers.
SUBJECTS AND METHODS
A total of 140 BAD and 253 SCZ patients were included in the study. Age, blood test results (fasting blood glucose, LDL-HDL-TC levels, hemogram values), blood pressure and heart rate, smoking status, antihypertensive drug use, and FHRS were calculated from the patient files, and sociodemographic information was recorded. In addition, ECG calculations were performed, and QT, QTc, TPe, TPe/QTc ratios and heart rate were measured.
RESULTS
When we evaluated the cardiac risk indexes of SCZ and BAD patients, we detected that FHRS was higher in smokers, female patients, and those with other medical diseases such as diabetes mellitus (DM) (p<0.05). In addition, we found that QTc rates, markers of ventricular repolarization, were associated with FHRS, the number of antipsychotics used, patient age, disease duration, and the number of hospitalizations. TPe and QT rates were found to increase in parallel with FHRS. In addition, a positive correlation was found between QTc rates in females, patients with DM, and those using additional medical drugs. (p<0.05)
CONCLUSIONS
In BAD and SCZ patients, diabetes diagnosis, other medical drug use, a high Framingham heart score, the number of antipsychotics, the disease duration, the patient's age, and an increased number of hospitalizations may increase the risk of cardiac arrhythmia. Therefore, possible cardiac risk should be considered in patients with chronic drug use, such as BAD and SCZ. Regulating the treatment and follow-up of this group of patients against possible cardiac risks will reduce cardiac mortality and morbidity
背景
在使用弗雷明汉心脏风险评分（Framingham Heart Risk Scoring，FHRS）的精神分裂症（Schizophrenia，SCZ）和双相情感障碍（Bipolar Affective Disorder，BAD）患者中，我们旨在通过计算心电图（Electrocardiogram，ECG）参数（QT、QTc、Tpe 和 TPE/QTc 比值）来研究可能的心律失常风险，这些参数是心室复极标志物。
受试者和方法
本研究共纳入 140 例 BAD 患者和 253 例 SCZ 患者。从患者病历中计算年龄、血液检查结果（空腹血糖、LDL-HDL-TC 水平、血常规值）、血压和心率、吸烟状况、使用降压药以及 FHRS，并记录社会人口统计学信息。此外，还进行了 ECG 计算，并测量 QT、QTc、Tpe、TPE/QTc 比值和心率。
结果
当我们评估 SCZ 和 BAD 患者的心脏风险指标时，我们发现吸烟者、女性患者以及患有糖尿病等其他疾病的患者 FHRS 更高（p<0.05）。此外，我们发现心室复极标志物 QTc 率与 FHRS、使用的抗精神病药物数量、患者年龄、疾病持续时间和住院次数有关。Tpe 和 QT 率随着 FHRS 的增加而平行增加。此外，还发现女性患者、糖尿病患者和使用其他药物的患者的 QTc 率呈正相关（p<0.05）。
结论
在 BAD 和 SCZ 患者中，糖尿病诊断、其他药物使用、高弗雷明汉心脏评分、抗精神病药物数量、疾病持续时间、患者年龄和住院次数增加可能会增加心律失常的风险。因此，慢性药物使用（如 BAD 和 SCZ）的患者可能需要考虑可能的心脏风险。调节这组患者的治疗和随访以应对可能的心脏风险将降低心脏死亡率和发病率。
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