Assessment of cardiac biomarkers and subclinical alterations in psychiatric and substance use populations

Individuals with schizophrenia, bipolar disorder, and alcohol or substance use disorders are at increased risk of cardiovascular complications. However, the biological mechanisms underlying psychiatric conditions and cardiac alterations, remain poorly understood. This study aimed to evaluate subclinical cardiovascular alterations in individuals with schizophrenia/bipolar disorder, and alcohol or substance use, without a diagnosis of heart disease, through the assessment of cardiac and inflammatory biomarkers. A cross-sectional study was conducted with 293 participants, including 65 patients with schizophrenia and/or bipolar disorder, 83 individuals with alcohol and/or substance use, and 145 healthy controls. Cardiac (myoglobin, CK-MB, NT-proBNP, and troponin I) and inflammatory (IL-6, IL-1β, TNF-α, and IL-8) biomarkers were assessed via immunoassays. Group comparisons were performed using Mann–Whitney tests, followed by multiple linear and logistic regression analyses adjusted for age, sex, BMI, and smoking status. Adjusted analyses showed higher NT-proBNP and IL-6 concentrations in both clinical groups, while increased CK-MB concentrations were observed in the schizophrenia/bipolar disorder group. Both clinical groups also presented lower TNF-α and IL-8 concentrations compared with controls. Logistic regression analyses demonstrated increased odds of elevated IL-6 in both clinical groups, increased odds of elevated myoglobin in schizophrenia/bipolar disorder, and increased odds of elevated NT-proBNP in alcohol/drug users. These findings suggest the presence of subclinical cardiovascular and immune-inflammatory alterations in psychiatric and substance-use populations, even in the absence of diagnosed cardiovascular disease, supporting the close interrelationship between mental and cardiovascular health.