Article

Metabolic syndrome and the risk of coronary heart disease in 367 patients treated with second-generation antipsychotic drugs.

The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY 11004, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.14). 04/2006; 67(4):575-83. DOI: 10.4088/JCP.v67n0408
Source: PubMed

ABSTRACT To examine the relationship between presence of metabolic syndrome and the risk of coronary heart disease (CHD) events (angina pectoris, myocardial infarction, and sudden cardiac death) in patients treated with second-generation antipsychotic medications.
367 adults treated with second-generation antipsychotics randomly selected from consecutive psychiatric admissions to a single hospital between August 1, 2004, and March 1, 2005, underwent assessments evaluating the presence of metabolic syndrome. The 10-year risk of CHD events was calculated according to the Framingham scoring system for age, smoking, total cholesterol, high-density lipoprotein (HDL)-cholesterol, blood pressure, and history of diabetes and was compared in patients with and without the metabolic syndrome.
Metabolic syndrome, present in 137 patients (37.3%), was associated with a significantly greater age- and race-adjusted 10-year risk of CHD events, i.e., 11.5% vs. 5.3% for men (risk ratio = 2.18, 95% CI = 1.88 to 2.48, p < .0001) and 4.5% vs. 2.3% for women (risk ratio = 1.94, 95% CI = 1.65 to 2.23, p = .0005). The increased risk of CHD events in patients with metabolic syndrome remained significant after the exclusion of diabetic patients. In a logistic regression analysis of variables independent of the Framingham scoring system, triglyceride levels (p < .0001), waist circumference (p = .035), and white race (p = .047) were significantly associated with the 10-year risk of CHD events (R2 = 0.134; p < .0001).
These data confirm the high prevalence of metabolic syndrome in patients receiving second-generation anti-psychotics, indicate that metabolic syndrome doubles the 10-year risk of CHD events in this population, and emphasize the importance of the "hypertriglyceridemic waist" for the identification of psychiatric patients at high risk of CHD.

0 Followers
 · 
158 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Severe mental illnesses are leading causes of disability worldwide. Their prevalence declines with age, possibly due to premature death. It is unclear, however, if people with severe mental disorders who reach older age still have lower life expectancy compared with their peers and if their causes of death differ.
    PLoS ONE 10/2014; 9(10):e111882. DOI:10.1371/journal.pone.0111882 · 3.53 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To estimate the economic burden of hyperglycemia and diabetes associated with lurasidone versus other atypical antipsychotics in schizophrenia. Methods: A discrete event simulation model was developed to conduct the analysis from both US payer and societal perspectives over a 3-year timeframe. The model, based on the values of metabolic parameters at 1 year of treatment, identified patients with hyperglycemia at that point and predicted incident cases of diabetes over 3 years using a risk equation from the Framingham Heart Study. Direct and indirect costs of diabetes and hyperglycemia were estimated, according to patients' disease status over time. Data on metabolic changes at 1 year were mainly from 4 clinical studies of lurasidone, supplemented with published data for other atypical antipsychotics. Cost inputs (2012 US dollars) were obtained from published sources. Results: Compared with olanzapine, risperidone, and quetiapine XR, lurasidone was predicted to result in 2,785,351, and 847 fewer hyperglycemia cases and 1,142,153, and 67 fewer incident diabetes cases per 10,000 patients over 3 years, respectively. Consequently, there was a reduction in the economic burden of diabetes and hyperglycemia by approximately $23 million, $2.9 million, and $3.4 million from a US payer perspective, and $28 million, $3.6 million, and $3.7 million from a societal perspective. Conclusion: Adverse metabolic effects of atypical antipsychotics could have substantial unfavorable clinical and economic consequences. Lurasidone may reduce these burdens and may be a treatment alternative for patients with schizophrenia.
    Open Medicine 05/2014; 1(1):1. DOI:10.2174/1874220301401010001
  • [Show abstract] [Hide abstract]
    ABSTRACT: Los pacientes esquizofrénicos tienen una tasa estandarizada de mortalidad que duplica la esperada para el resto de la población. Gran parte de la morbimortalidad en estos pacientes se debe a enfermedades cardiovasculares. El síndrome metabólico tiene una alta prevalencia entre los esquizofrénicos y puede aumentar entre 2 y 4 veces el riesgo coronario. El objetivo del presente estudio es realizar un análisis de las escasas publicaciones sobre la prevalencia de síndrome metabólico en los pacientes esquizofrénicos y de las variables sociodemográficas, antropométricas, clínicas y psicofarmacológicas que se relacionan con él. Se evidencia en la mayoría de las publicaciones una elevada prevalencia de síndrome metabólico en pacientes con esquizofrenia, por lo que la prevención, el diagnóstico y el tratamiento de sus components son un objetivo fundamental para disminuir el riesgo cardiovascular en estos sujetos.
    08/2006; 13(4):127-135. DOI:10.1016/S1134-5934(06)75353-2

Preview

Download
4 Downloads
Available from