Metabolic syndrome doubled the estimated 10-year risk of CHD events in patients on second-generation antipsychotics for both men (11.5% vs 5.3%, RR 2.18) and women (4.5% vs 2.3%, RR 1.94).
Cross-Sectional (n=367)
No
Effect estimate: RR 2.18 (men), RR 1.94 (women) (95% CI 1.88-2.48 (men), 1.65-2.23 (women))
p-value: p=<.0001 (men), .0005 (women)
OBJECTIVE: To examine the relationship between presence of metabolic syndrome and the risk of coronary heart disease (CHD) events (angina pectoris, myocardial infarction, and sudden cardiac death) in patients treated with second-generation antipsychotic medications. METHOD: 367 adults treated with second-generation antipsychotics randomly selected from consecutive psychiatric admissions to a single hospital between August 1, 2004, and March 1, 2005, underwent assessments evaluating the presence of metabolic syndrome. The 10-year risk of CHD events was calculated according to the Framingham scoring system for age, smoking, total cholesterol, high-density lipoprotein (HDL)-cholesterol, blood pressure, and history of diabetes and was compared in patients with and without the metabolic syndrome. RESULTS: Metabolic syndrome, present in 137 patients (37.3%), was associated with a significantly greater age- and race-adjusted 10-year risk of CHD events, i.e., 11.5% vs. 5.3% for men (risk ratio = 2.18, 95% CI = 1.88 to 2.48, p < .0001) and 4.5% vs. 2.3% for women (risk ratio = 1.94, 95% CI = 1.65 to 2.23, p = .0005). The increased risk of CHD events in patients with metabolic syndrome remained significant after the exclusion of diabetic patients. In a logistic regression analysis of variables independent of the Framingham scoring system, triglyceride levels (p < .0001), waist circumference (p = .035), and white race (p = .047) were significantly associated with the 10-year risk of CHD events (R2 = 0.134; p < .0001). CONCLUSIONS: These data confirm the high prevalence of metabolic syndrome in patients receiving second-generation anti-psychotics, indicate that metabolic syndrome doubles the 10-year risk of CHD events in this population, and emphasize the importance of the "hypertriglyceridemic waist" for the identification of psychiatric patients at high risk of CHD.
Correll et al. (Sat,) conducted a cross-sectional in Patients treated with second-generation antipsychotic drugs (n=367). Metabolic syndrome vs. Without metabolic syndrome was evaluated on 10-year risk of CHD events (angina pectoris, myocardial infarction, and sudden cardiac death) (RR 2.18 (men), RR 1.94 (women), 95% CI 1.88-2.48 (men), 1.65-2.23 (women), p=<.0001 (men), .0005 (women)). Metabolic syndrome doubled the estimated 10-year risk of CHD events in patients on second-generation antipsychotics for both men (11.5% vs 5.3%, RR 2.18) and women (4.5% vs 2.3%, RR 1.94).