Cardiovascular events in hospitalised patients with schizophrenia: a survival analysis

Abstract

Objective: To evaluate the occurrence of cardiovascular (CV), cerebrovascular events and mortality rates, and compare the predictive ability of two scores, Framingham Risk Score (FRS) and Atherosclerotic Cardiovascular Disease (ASCVD), of detecting a cardiovascular event in a cohort of schizophrenic patients.

Methods: A cohort of 329 hospitalised schizophrenic patients is being monitored since 1 January 2013. Patients’ file review was performed to detect the CV events of interest.

Results: Out of the 329 patients with schizophrenia, with a mean study follow-up of 41.07 ± 12.55 months, 29 cardiovascular events were recorded; of those events, we recorded 4 myocardial infarction, 1 stroke, 6 heart failure and 18 cardiovascular deaths. The major composite outcome of cardiovascular events rate was equal to 9.0 per 100 patient-years. The secondary composite outcome of cardiovascular events rate was equal to 7.2 per 100 patient-years (0.072 events per patient). The association between survival curve of patients with high and low CVR according to FRS score tended to significance (RR = 1.90, p = .078). Patients classified as high cardiovascular risk according to ASCVD presented a reduced cardiovascular survival (RR = 3.35, p = .005).

Conclusion: The ASCVD items should be included in the medical assessment in any patient with severe mental illness.

Key points

• The major composite outcome of cardiovascular events rate was equal to 9.0 per 100 patient-years.

• The secondary composite outcome of cardiovascular events rate was equal to 7.2 per 100 patient-years (0.072 events per patient).

• The association between survival curve of patients with high and low CVR according to FRS score tended to significance.

• Patients classified as high cardiovascular risk according to ASCVD presented a reduced cardiovascular survival.

• The ASCVD items should be included in the medical assessment in any patient with severe mental illness.

Keywords:

• Cardiovascular disease
• schizophrenia
• Framingham risk score
• ASCVD [AHA/ACC 2013]

Disclosure statement

No potential conflict of interest was reported by the authors.