Electrocardiogram Characteristics and Their Association With Psychotropic Drugs Among Patients With Schizophrenia

Christoffer Polcwiartek, Kristian Kragholm, Steen M Hansen, Brett D Atwater, Daniel J Friedman, Carlo A Barcella, Claus Graff, Jonas B Nielsen, Adrian Pietersen, Jimmi Nielsen, Peter Søgaard, Christian Torp-Pedersen, Svend E Jensen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

There are limited data on electrocardiogram (ECG) characteristics and their association with psychotropic drugs in schizophrenia. Using a cross-sectional design, we included Danish primary care patients with first-time digital ECGs from 2001 to 2015. Patients diagnosed with schizophrenia before ECG recording were matched 1:5 on age, sex, and ECG recording year to controls without psychiatric disease. Multivariable logistic regression was used to compute odds ratios (ORs) with 95\% confidence intervals (CIs). We included 4486 patients with schizophrenia matched with 22 430 controls (median age, 47 years; male, 55\. Between groups, the prevalence of abnormal ECGs was similar (54\ P = .536), but patients with schizophrenia demonstrated higher median heart rate (79 vs 69 beats per minute, P \lt; .001) and Fridericia-corrected QT (QTc) interval (416 vs 412 ms, P \lt; .001) than controls. QTc prolongation was also more prevalent among patients with schizophrenia (3.4\% vs 1.1\ P \lt; .001), and so were pathological Q waves (5.3\% vs 3.9\ P \lt; .001). Patients with schizophrenia less frequently demonstrated left ventricular hypertrophy (6.1\% vs 9.6\ P \lt; .001) and atrial fibrillation or flutter (0.7\% vs 1.4\ P \lt; .001). Among patients with schizophrenia only, particularly antipsychotics were associated with abnormal ECGs (OR, 1.20; 95\% CI, 1.04\1.39). Patients with schizophrenia demonstrate a different cardiovascular risk profile than matched controls without psychiatric disease, with higher prevalence of elevated heart rate, QTc prolongation, and pathological Q waves, and lower prevalence of left ventricular hypertrophy and atrial fibrillation or flutter. Particularly antipsychotics were associated with abnormal ECGs. This underscores an integrated care approach when ECG abnormalities are detected in this group.
OriginalsprogEngelsk
TidsskriftSchizophrenia Bulletin
ISSN0586-7614
DOI
StatusE-pub ahead of print - 1 jun. 2019

Citer dette

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title = "Electrocardiogram Characteristics and Their Association With Psychotropic Drugs Among Patients With Schizophrenia",
abstract = "There are limited data on electrocardiogram (ECG) characteristics and their association with psychotropic drugs in schizophrenia. Using a cross-sectional design, we included Danish primary care patients with first-time digital ECGs from 2001 to 2015. Patients diagnosed with schizophrenia before ECG recording were matched 1:5 on age, sex, and ECG recording year to controls without psychiatric disease. Multivariable logistic regression was used to compute odds ratios (ORs) with 95\{\%} confidence intervals (CIs). We included 4486 patients with schizophrenia matched with 22 430 controls (median age, 47 years; male, 55\. Between groups, the prevalence of abnormal ECGs was similar (54\ P = .536), but patients with schizophrenia demonstrated higher median heart rate (79 vs 69 beats per minute, P \lt; .001) and Fridericia-corrected QT (QTc) interval (416 vs 412 ms, P \lt; .001) than controls. QTc prolongation was also more prevalent among patients with schizophrenia (3.4\{\%} vs 1.1\ P \lt; .001), and so were pathological Q waves (5.3\{\%} vs 3.9\ P \lt; .001). Patients with schizophrenia less frequently demonstrated left ventricular hypertrophy (6.1\{\%} vs 9.6\ P \lt; .001) and atrial fibrillation or flutter (0.7\{\%} vs 1.4\ P \lt; .001). Among patients with schizophrenia only, particularly antipsychotics were associated with abnormal ECGs (OR, 1.20; 95\{\%} CI, 1.04\1.39). Patients with schizophrenia demonstrate a different cardiovascular risk profile than matched controls without psychiatric disease, with higher prevalence of elevated heart rate, QTc prolongation, and pathological Q waves, and lower prevalence of left ventricular hypertrophy and atrial fibrillation or flutter. Particularly antipsychotics were associated with abnormal ECGs. This underscores an integrated care approach when ECG abnormalities are detected in this group.",
author = "Christoffer Polcwiartek and Kristian Kragholm and Hansen, {Steen M} and Atwater, {Brett D} and Friedman, {Daniel J} and Barcella, {Carlo A} and Claus Graff and Nielsen, {Jonas B} and Adrian Pietersen and Jimmi Nielsen and Peter S{\o}gaard and Christian Torp-Pedersen and Jensen, {Svend E}",
year = "2019",
month = "6",
day = "1",
doi = "10.1093/schbul/sbz064",
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Electrocardiogram Characteristics and Their Association With Psychotropic Drugs Among Patients With Schizophrenia. / Polcwiartek, Christoffer; Kragholm, Kristian; Hansen, Steen M; Atwater, Brett D; Friedman, Daniel J; Barcella, Carlo A; Graff, Claus; Nielsen, Jonas B; Pietersen, Adrian; Nielsen, Jimmi; Søgaard, Peter; Torp-Pedersen, Christian; Jensen, Svend E.

I: Schizophrenia Bulletin, 01.06.2019.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Electrocardiogram Characteristics and Their Association With Psychotropic Drugs Among Patients With Schizophrenia

AU - Polcwiartek, Christoffer

AU - Kragholm, Kristian

AU - Hansen, Steen M

AU - Atwater, Brett D

AU - Friedman, Daniel J

AU - Barcella, Carlo A

AU - Graff, Claus

AU - Nielsen, Jonas B

AU - Pietersen, Adrian

AU - Nielsen, Jimmi

AU - Søgaard, Peter

AU - Torp-Pedersen, Christian

AU - Jensen, Svend E

PY - 2019/6/1

Y1 - 2019/6/1

N2 - There are limited data on electrocardiogram (ECG) characteristics and their association with psychotropic drugs in schizophrenia. Using a cross-sectional design, we included Danish primary care patients with first-time digital ECGs from 2001 to 2015. Patients diagnosed with schizophrenia before ECG recording were matched 1:5 on age, sex, and ECG recording year to controls without psychiatric disease. Multivariable logistic regression was used to compute odds ratios (ORs) with 95\% confidence intervals (CIs). We included 4486 patients with schizophrenia matched with 22 430 controls (median age, 47 years; male, 55\. Between groups, the prevalence of abnormal ECGs was similar (54\ P = .536), but patients with schizophrenia demonstrated higher median heart rate (79 vs 69 beats per minute, P \lt; .001) and Fridericia-corrected QT (QTc) interval (416 vs 412 ms, P \lt; .001) than controls. QTc prolongation was also more prevalent among patients with schizophrenia (3.4\% vs 1.1\ P \lt; .001), and so were pathological Q waves (5.3\% vs 3.9\ P \lt; .001). Patients with schizophrenia less frequently demonstrated left ventricular hypertrophy (6.1\% vs 9.6\ P \lt; .001) and atrial fibrillation or flutter (0.7\% vs 1.4\ P \lt; .001). Among patients with schizophrenia only, particularly antipsychotics were associated with abnormal ECGs (OR, 1.20; 95\% CI, 1.04\1.39). Patients with schizophrenia demonstrate a different cardiovascular risk profile than matched controls without psychiatric disease, with higher prevalence of elevated heart rate, QTc prolongation, and pathological Q waves, and lower prevalence of left ventricular hypertrophy and atrial fibrillation or flutter. Particularly antipsychotics were associated with abnormal ECGs. This underscores an integrated care approach when ECG abnormalities are detected in this group.

AB - There are limited data on electrocardiogram (ECG) characteristics and their association with psychotropic drugs in schizophrenia. Using a cross-sectional design, we included Danish primary care patients with first-time digital ECGs from 2001 to 2015. Patients diagnosed with schizophrenia before ECG recording were matched 1:5 on age, sex, and ECG recording year to controls without psychiatric disease. Multivariable logistic regression was used to compute odds ratios (ORs) with 95\% confidence intervals (CIs). We included 4486 patients with schizophrenia matched with 22 430 controls (median age, 47 years; male, 55\. Between groups, the prevalence of abnormal ECGs was similar (54\ P = .536), but patients with schizophrenia demonstrated higher median heart rate (79 vs 69 beats per minute, P \lt; .001) and Fridericia-corrected QT (QTc) interval (416 vs 412 ms, P \lt; .001) than controls. QTc prolongation was also more prevalent among patients with schizophrenia (3.4\% vs 1.1\ P \lt; .001), and so were pathological Q waves (5.3\% vs 3.9\ P \lt; .001). Patients with schizophrenia less frequently demonstrated left ventricular hypertrophy (6.1\% vs 9.6\ P \lt; .001) and atrial fibrillation or flutter (0.7\% vs 1.4\ P \lt; .001). Among patients with schizophrenia only, particularly antipsychotics were associated with abnormal ECGs (OR, 1.20; 95\% CI, 1.04\1.39). Patients with schizophrenia demonstrate a different cardiovascular risk profile than matched controls without psychiatric disease, with higher prevalence of elevated heart rate, QTc prolongation, and pathological Q waves, and lower prevalence of left ventricular hypertrophy and atrial fibrillation or flutter. Particularly antipsychotics were associated with abnormal ECGs. This underscores an integrated care approach when ECG abnormalities are detected in this group.

U2 - 10.1093/schbul/sbz064

DO - 10.1093/schbul/sbz064

M3 - Journal article

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

SN - 0586-7614

ER -