Why the study?
The study analyzed time trends in the use of coronary procedures, guideline-based drugs, and 1-year mortality following acute coronary syndrome in patients with versus without bipolar disorder.
Do patients with bipolar disorder have different rates of coronary procedures, guideline-based drug use, and mortality following acute coronary syndrome compared to patients without psychiatric disease?
Do patients with bipolar disorder have different rates of coronary procedures, guideline-based drug use, and mortality following acute coronary syndrome compared to patients without psychiatric disease?
Patients with bipolar disorder experiencing acute coronary syndrome continue to face persistent disparities in invasive coronary treatments and experience an unchanged mortality gap compared to patients without psychiatric disease.
Patients with BD and ACS may receive fewer procedures; hypothesis-generating for care disparities and outcome differences.
AIM: This study analyzed time trends in the use of coronary procedures, guideline-based drugs, and 1-year all-cause and presumed cardiovascular mortality (CV) following acute coronary syndrome (ACS) in patients with and without bipolar disorder (BD). METHOD: Using Danish registries 497 patients with ACS and BD in the period 1996-2016 were matched 1:2 on age, sex and year of ACS to patients without preexisting psychiatric disease. RESULTS: Patients with BD and ACS received fewer coronary angiography (CAG) compared to psychiatric healthy controls (PHC). However, the difference between the populations decreased over time. For percutaneous coronary intervention (PCI) and coronary artery bypass (CABG) no differences in trend over time were found. In general patients with BD redeemed fewer prescriptions of guideline-based tertiary prophylactic drugs compared to PHCs. The difference remains constant over time for all drugs except for acetylsalicylic acid, lipid-lowering drugs and beta blockers, where the difference decreased. The 1-year all-cause mortality gap and the presumed CV mortality gap remained unchanged. CONCLUSION: Despite improvements in treatment disparities regarding CAG, acetylsalicylic acid, lipid-lowering drugs and beta-blockers, the treatment gap remained unchanged concerning PCI and CABG. Likewise, patients with BD experienced a lower rate of the remaining redeemed prescriptions. The overall crude mortality risk ratio for patients with BD experiencing ACS remained unchanged over the study period compared to PHC.
No takes yet. Share an insight, caveat, or question.
Philipsen et al. (2022) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: