Current use of antipsychotics was associated with a 3-fold increase in the risk of sudden cardiac death, with the highest risk among short-term users and those taking butyrophenones.
Case-Control
Yes
Does current use of antipsychotics increase the risk of sudden cardiac death in a community-dwelling population?
Current use of antipsychotics in a general population is associated with a 3-fold increased risk of sudden cardiac death, particularly with recent use and butyrophenones.
Effect estimate: 3-fold increase
BACKGROUND: Antipsychotics have been associated with prolongation of the corrected QT interval and sudden cardiac death. Only a few epidemiological studies have investigated this association. We performed a case-control study to investigate the association between use of antipsychotics and sudden cardiac death in a well-defined community-dwelling population. METHODS: We performed a population-based case-control study in the Integrated Primary Care Information (IPCI) project, a longitudinal observational database with complete medical records from 150 general practitioners. All instances of death between January 1, 1995, and April 1, 2001, were reviewed. Sudden cardiac death was classified based on time between onset of cardiovascular symptoms and death. For each case, up to 10 random controls were matched for age, sex, date of sudden death, and practice. Exposure at the index date was categorized as 3 mutually exclusive groups of current use, past use, and nonuse. RESULTS: The study population comprised 554 cases of sudden cardiac death. Current use of antipsychotics was associated with a 3-fold increase in risk of sudden cardiac death. The risk of sudden cardiac death was highest among those using butyrophenone antipsychotics, those with a defined daily dose equivalent of more than 0.5 and short-term (</=90 days) users. The association with current antipsychotic use was higher for witnessed cases (n = 334) than for unwitnessed cases. CONCLUSIONS: Current use of antipsychotics in a general population is associated with an increased risk of sudden cardiac death, even at a low dose and for indications other than schizophrenia. Risk of sudden cardiac death was highest among recent users but remained elevated during long-term use.
Straus et al. (Mon,) conducted a case-control in Sudden cardiac death. Antipsychotics vs. Past use and nonuse was evaluated on Sudden cardiac death (3-fold increase). Current use of antipsychotics was associated with a 3-fold increase in the risk of sudden cardiac death, with the highest risk among short-term users and those taking butyrophenones.
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