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Major adverse cardiovascular events following acute coronary syndrome in patients with bipolar disorder

Attar, Rubina LU orcid ; Valentin, Jan Brink ; Andell, Pontus LU ; Nielsen, René Ernst and Jensen, Svend Eggert (2022) In International Journal of Cardiology 363. p.1-5
Abstract

Background: Persons with bipolar disorder (BD) have a higher cardiovascular mortality compared to the general population, partially explained by the increased burden of cardiovascular risk factors. Research regarding outcomes following acute coronary syndrome (ACS) in this population remains scarce. Design: This Danish register-based study included patients diagnosed with BD and ACS in the period between January 1st, 1995, to December 31st, 2013. Study participants were matched 1:2 to patients without BD on sex, date of birth, time of ACS diagnosis and comorbidities. The primary outcome of interest was major adverse cardiovascular events (MACE) a composite of all-cause mortality, reinfarction or stroke. MACE and its individual... (More)

Background: Persons with bipolar disorder (BD) have a higher cardiovascular mortality compared to the general population, partially explained by the increased burden of cardiovascular risk factors. Research regarding outcomes following acute coronary syndrome (ACS) in this population remains scarce. Design: This Danish register-based study included patients diagnosed with BD and ACS in the period between January 1st, 1995, to December 31st, 2013. Study participants were matched 1:2 to patients without BD on sex, date of birth, time of ACS diagnosis and comorbidities. The primary outcome of interest was major adverse cardiovascular events (MACE) a composite of all-cause mortality, reinfarction or stroke. MACE and its individual components were compared between patients with and without BD. Results: 796 patients with BD were compared to 1592 patients without BD, both groups had a mean age of first ACS of 66.5 years. MACE was 38% increased (HR 1.38 95% CI 1.25–1.54), all-cause mortality was 71% increased (HR 1.71 95% CI 1.52–1.92), stroke was 94% increased (HR 1.94 95% CI 1.56–2.41) and reinfarction rates were 17% lower (HR 0.83 95% CI 0.69–1.00) in the BD population compared to the population without BD. We also found higher prevalences of heart failure (9.1% vs. 6.5%), valve disease (5.3% vs. 3.5%), anemia (8.7% vs. 5.8%), chronic obstructive pulmonary disease (13.4% vs. 9.3%) and stroke (11.8% vs. 7.8%) in the population with BD at baseline, all p-values <0.05. Conclusion: Bipolar disorder was associated with a higher risk of composite MACE, all-cause mortality, and stroke, after ACS compared to patients without BD.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute coronary syndrome, Acute myocardial infarction, Bipolar disorder, Epidemiology
in
International Journal of Cardiology
volume
363
pages
5 pages
publisher
Elsevier
external identifiers
  • scopus:85133750060
  • pmid:35716946
ISSN
0167-5273
DOI
10.1016/j.ijcard.2022.06.036
language
English
LU publication?
yes
id
059fc81a-91a6-4cee-a9a9-977ecbf1bb6d
date added to LUP
2022-09-07 14:48:17
date last changed
2024-06-13 19:08:56
@article{059fc81a-91a6-4cee-a9a9-977ecbf1bb6d,
  abstract     = {{<p>Background: Persons with bipolar disorder (BD) have a higher cardiovascular mortality compared to the general population, partially explained by the increased burden of cardiovascular risk factors. Research regarding outcomes following acute coronary syndrome (ACS) in this population remains scarce. Design: This Danish register-based study included patients diagnosed with BD and ACS in the period between January 1st, 1995, to December 31st, 2013. Study participants were matched 1:2 to patients without BD on sex, date of birth, time of ACS diagnosis and comorbidities. The primary outcome of interest was major adverse cardiovascular events (MACE) a composite of all-cause mortality, reinfarction or stroke. MACE and its individual components were compared between patients with and without BD. Results: 796 patients with BD were compared to 1592 patients without BD, both groups had a mean age of first ACS of 66.5 years. MACE was 38% increased (HR 1.38 95% CI 1.25–1.54), all-cause mortality was 71% increased (HR 1.71 95% CI 1.52–1.92), stroke was 94% increased (HR 1.94 95% CI 1.56–2.41) and reinfarction rates were 17% lower (HR 0.83 95% CI 0.69–1.00) in the BD population compared to the population without BD. We also found higher prevalences of heart failure (9.1% vs. 6.5%), valve disease (5.3% vs. 3.5%), anemia (8.7% vs. 5.8%), chronic obstructive pulmonary disease (13.4% vs. 9.3%) and stroke (11.8% vs. 7.8%) in the population with BD at baseline, all p-values &lt;0.05. Conclusion: Bipolar disorder was associated with a higher risk of composite MACE, all-cause mortality, and stroke, after ACS compared to patients without BD.</p>}},
  author       = {{Attar, Rubina and Valentin, Jan Brink and Andell, Pontus and Nielsen, René Ernst and Jensen, Svend Eggert}},
  issn         = {{0167-5273}},
  keywords     = {{Acute coronary syndrome; Acute myocardial infarction; Bipolar disorder; Epidemiology}},
  language     = {{eng}},
  month        = {{09}},
  pages        = {{1--5}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Cardiology}},
  title        = {{Major adverse cardiovascular events following acute coronary syndrome in patients with bipolar disorder}},
  url          = {{http://dx.doi.org/10.1016/j.ijcard.2022.06.036}},
  doi          = {{10.1016/j.ijcard.2022.06.036}},
  volume       = {{363}},
  year         = {{2022}},
}