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Título em portugués: Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness : a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls
Autor: Correll, Christoph U.
Solmi, Marco
Veronese, Nicola
Bortolato, Beatrice
Rosson, Stella
Santonastaso, Paolo
Thapa-Chhetri, Nita
Fornaro, Michele
Gallicchio, Davide
Collantoni, Enrico
Pigato, Giorgio
Favaro, Angela
Monaco, Francesco Monaco
Kohler, Cristiano
Vancampfort, Davy
Ward, Philip B.
Gaughran, Fiona
Carvalho, André F.
Stubbs, Brendon
Palabras clave : Transtornos Mentais
Esquizofrenia
Schizophrenia
Fecha de publicación : jun-2017
Editorial : World Psychiatry
Citación : CORRELL, Christoph U. et al. Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness : a large-scale meta-analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, Milan, v. 16, p. 163-180, jun. 2017.
Resumen en inglés: People with severe mental illness (SMI) – schizophrenia, bipolar disorder and major depressive disorder – appear at risk for cardiovascular disease (CVD), but a comprehensive meta-analysis is lacking. We conducted a large-scale meta-analysis assessing the prevalence and incidence of CVD; coronary heart disease; stroke, transient ischemic attack or cerebrovascular disease; congestive heart failure; peripheral vascular disease; and CVD-related death in SMI patients (N53,211,768) versus controls (N5113,383,368) (92 studies). The pooled CVD prevalence in SMI patients (mean age 50 years) was 9.9% (95% CI: 7.4-13.3). Adjusting for a median of seven confounders, patients had significantly higher odds of CVD versus controls in cross-sectional studies (odds ratio, OR51.53, 95% CI: 1.27-1.83; 11 studies), and higher odds of coronary heart disease (OR51.51, 95% CI: 1.47-1.55) and cerebrovascular disease (OR51.42, 95% CI: 1.21-1.66). People with major depressive disorder were at increased risk for coronary heart disease, while those with schizophrenia were at increased risk for coronary heart disease, cerebrovascular disease and congestive heart failure. Cumulative CVD incidence in SMI patients was 3.6% (95% CI: 2.7-5.3) during a median follow-up of 8.4 years (range 1.8-30.0). Adjusting for a median of six confounders, SMI patients had significantly higher CVD incidence than controls in longitudinal studies (hazard ratio, HR51.78, 95% CI: 1.60-1.98; 31 studies). The incidence was also higher for coronary heart disease (HR51.54, 95% CI: 1.30-1.82), cerebrovascular disease (HR51.64, 95% CI: 1.26-2.14), congestive heart failure (HR52.10, 95% CI: 1.64-2.70), and CVDrelated death (HR51.85, 95% CI: 1.53-2.24). People with major depressive disorder, bipolar disorder and schizophrenia were all at increased risk of CVD-related death versus controls. CVD incidence increased with antipsychotic use (p50.008), higher body mass index (p50.008) and higher baseline CVD prevalence (p50.03) in patients vs. controls. Moreover, CVD prevalence (p50.007), but not CVD incidence (p50.21), increased in more recently conducted studies. This large-scale meta-analysis confirms that SMI patients have significantly increased risk of CVD and CVD-related mortality, and that elevated body mass index, antipsychotic use, and CVD screening and management require urgent clinical attention.
URI : http://www.repositorio.ufc.br/handle/riufc/25138
metadata.dc.type: Artigo de Periódico
ISSN : 1723-8617
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