TY - JOUR
T1 - Coronary Artery Calcification and Mortality Risk in Patients With Severe Mental Illness
T2 - A Retrospective Multicenter Cohort Study
AU - Kugathasan, Pirathiv
AU - Johansen, Martin Berg
AU - Jensen, Mikkel Bak
AU - Aagaard, Jørgen
AU - Nielsen, René Ernst
AU - Jensen, Svend Eggert
PY - 2019/3
Y1 - 2019/3
N2 - Background Cardiovascular mortality is the leading contributor to the shortened life expectancy in patients with severe mental illness (SMI), but efforts to predict cardiovascular outcomes in these patients have been lacking. In this study, we aimed to determine the severity of coronary artery calcification (CAC), and its effect on mortality rates in patients with SMI, compared with the general population. Methods All individuals with a registered cardiac computed tomography for calcium scoring in the Western Denmark Heart Registry, from January 1, 2008 to December 31, 2016, were included. We identified patients diagnosed with SMI ( International Classification of Diseases, Tenth Revision: F20, F30, F31), whereas the remaining individuals were used as a comparison group. Results Among 48 757 individuals, including 564 patients with SMI (1.2%), we found no difference in CAC score between patients with SMI and the comparison group. SMI patients with CAC >100 had an increased mortality rate (hazard ratio, 3.16; 95% CI, 1.41-7.06), as well as SMI patients with CAC <100 (hazard ratio, 3.95; 95% CI, 2.36-6.62), compared with the comparison group with CAC <100 as reference, adjusted for age, sex, and calendar period. Conclusions Patients with SMI have increased cardiovascular risks, but show no difference in CAC score, compared with the comparison group. Mortality rates were increased in patients with SMI, independent of CAC severity; however, the relatively large number of noncardiovascular causes of death in this sample might indicate other contributing factors to death than coronary artery disease in this sample of SMI patients.
AB - Background Cardiovascular mortality is the leading contributor to the shortened life expectancy in patients with severe mental illness (SMI), but efforts to predict cardiovascular outcomes in these patients have been lacking. In this study, we aimed to determine the severity of coronary artery calcification (CAC), and its effect on mortality rates in patients with SMI, compared with the general population. Methods All individuals with a registered cardiac computed tomography for calcium scoring in the Western Denmark Heart Registry, from January 1, 2008 to December 31, 2016, were included. We identified patients diagnosed with SMI ( International Classification of Diseases, Tenth Revision: F20, F30, F31), whereas the remaining individuals were used as a comparison group. Results Among 48 757 individuals, including 564 patients with SMI (1.2%), we found no difference in CAC score between patients with SMI and the comparison group. SMI patients with CAC >100 had an increased mortality rate (hazard ratio, 3.16; 95% CI, 1.41-7.06), as well as SMI patients with CAC <100 (hazard ratio, 3.95; 95% CI, 2.36-6.62), compared with the comparison group with CAC <100 as reference, adjusted for age, sex, and calendar period. Conclusions Patients with SMI have increased cardiovascular risks, but show no difference in CAC score, compared with the comparison group. Mortality rates were increased in patients with SMI, independent of CAC severity; however, the relatively large number of noncardiovascular causes of death in this sample might indicate other contributing factors to death than coronary artery disease in this sample of SMI patients.
KW - bipolar disorder
KW - calcium
KW - cardiovascular disease
KW - computed tomography angiography
KW - coronary artery disease
KW - morbidity
KW - mortality
KW - schizophrenia
UR - http://www.scopus.com/inward/record.url?scp=85062872817&partnerID=8YFLogxK
U2 - 10.1161/CIRCIMAGING.118.008236
DO - 10.1161/CIRCIMAGING.118.008236
M3 - Journal article
C2 - 30866646
SN - 1941-9651
VL - 12
JO - Circulation. Cardiovascular Imaging
JF - Circulation. Cardiovascular Imaging
IS - 3
M1 - e008236
ER -