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Prevalence, incidence and comparative meta-analysis of all-cause and specific-cause cardiovascular disease in patients with serious mental illness

Published online by Cambridge University Press:  23 March 2020

M. Solmi ,
N. Veronese ,
B. Beatrice ,
R. Stella ,
S. Paolo ,
G. Davide ,
E. Collantoni ,
G. Pigato ,
A. Favaro  and
B. Stubbs
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M. Solmi
Affiliation:
University of Padua, Neuroscience Department, Padua, Italy Institute for clinical Research and Education in Medicine, Neuroscience Department, Padua, Italy ULSS 17, Mental Health Department, Padua, Italy
N. Veronese
Affiliation:
Institute for clinical Research and Education in Medicine, Neuroscience Department, Padua, Italy University of Padua, Department of Medicine, Padua, Italy
B. Beatrice
Affiliation:
Institute for clinical Research and Education in Medicine, Neuroscience Department, Padua, Italy ULSS 10, Mental Health Department, Portogruaro, Italy
R. Stella
Affiliation:
University of Padua, Neuroscience Department, Padua, Italy
S. Paolo
Affiliation:
University of Padua, Neuroscience Department, Padua, Italy
G. Davide
Affiliation:
University of Padua, Neuroscience Department, Padua, Italy
E. Collantoni
Affiliation:
University of Padua, Neuroscience Department, Padua, Italy
G. Pigato
Affiliation:
University of Padua, Neuroscience Department, Padua, Italy
A. Favaro
Affiliation:
University of Padua, Neuroscience Department, Padua, Italy
B. Stubbs
Affiliation:
South London and Maudsley NHS Foundation Trust, Physiotherapy Department, London, United Kingdom King's College London, Health Service and Population Research Department- Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
A.F. Carvalho
Affiliation:
Faculty of Medicine, Federal University of Ceará, Departmend of Clinical Medicine and Translational Psychiatry Research Group, Fortaleza, Brazil
D. Vacampfort
Affiliation:
KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium KU Leuven, University Psychiatric Center KU Leuven, Leuven, Belgium
C.U. Correll
Affiliation:
The Zucker Hillside Hospital, Psychiatry Research, New York, USA Albert Einstein College of Medicine, Medicine, New York, USA The Feinstein Institute for Medical Research, Research, New York, USA Hofstra Northwell School of Medicine, Medicine, New York, USA

Abstract

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Patients with severe mental illness (SMI) have been described at higher risk of cardiovascular disease (CVD). The aim of this systematic review and meta-analysis was to quantify prevalence, incidence, cross-sectional association and longitudinal increased risk of coronary heart disease (CHD), stroke, transient ischemic attack and cerebrovascular disease (CBVD), heart failure (HF), peripheral vascular disease (PVD), death due to CVD, and any CVD in patients with SMI. We included 92 studies, with a total population of 3,371,461 patients (BD = 241,226, MDD = 476,102, SCZ = 1,721,586, SMI = 932,547) and 113,925,577 controls. Pooled prevalence of any CVD in SMI was 9.9% (95% CI = 7.4–13.3) (33 studies, 360,144 patients). Compared to controls, after adjusting for a median of 7 confounders, SMI was associated with higher risk of CVD in cross-sectional studies, OR:1.53 (95% CI = 1.27–1.83) (11 studies), with CHD OR: 1.51 (95% CI = 1.47–1.55) (5 studies), with CBVD OR: 1.42 (95% CI = 1.21–1.66) (6 studies), and tended to be associated with HF OR: 1.28 (95% CI = 0.99–1.65) (4 studies). Cumulative incidence was 3.6 CVD events in a median follow-up period of 8.4 years (range: 1.76–30). After considering a median of 6 confounders, SMI was associated with higher longitudinal risk of CVD in longitudinal studies HR: 1.78 (95% CI = 1.6, 1.98) (31 studies), of CHD: HR: 1.54 (95% CI 1.30–1.82) (18 studies), of CBVD HR: 1.64 (95% CI 1.26–2.14) (11 studies), of HF HR:2.10 (95% CI 1.64–2.70) (2 studies), of PVD, unadjusted RR: 3.11 (95% CI 2.46–3.91) (3 studies), of death due to CVD, HR 1.85 (95% CI 1.53–2.24) (16 studies). In this meta-analysis, the association between SMI and CVD has been quantified in a world representative sample; we suggest prevention of CVD should be warranted as standard care in SMI.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
e-Poster Walk: Consultation liaison psychiatry and psychosomatics - Part 2
Information
European Psychiatry , Volume 41 , Issue S1: Abstract of the 25th European Congress of Psychiatry , April 2017 , pp. S319 - S320
Copyright
Copyright © European Psychiatric Association 2017
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