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Conference Paper: MORTALITY, REVASCULARIZATION AND CARDIOPROTECTIVE PHARMACOTHERAPY AFTER ACUTE CORONARY SYNDROME IN PATIENTS WITH PSYCHOTIC DISORDERS: A POPULATION-BASED COHORT STUDY

TitleMORTALITY, REVASCULARIZATION AND CARDIOPROTECTIVE PHARMACOTHERAPY AFTER ACUTE CORONARY SYNDROME IN PATIENTS WITH PSYCHOTIC DISORDERS: A POPULATION-BASED COHORT STUDY
Authors
Issue Date2020
PublisherOxford University Press. The Journal's web site is located at http://schizophreniabulletin.oxfordjournals.org/
Citation
Schizophrenia International Research Society (SIRS) Annual Congress 2020, Florence, Italy, 4-8 April 2020. SIRS 2020 Abstracts In Schizophrenia Bulletin, 2020, v. 46 n. S1, p. S65-S66, abstract no. S83 How to Cite?
AbstractBackground: Ischemic heart disease is the leading cause of premature mortality in psychotic disorders. The authors aimed to examine short-term mortality, cardiovascular complications, revascularization and cardioprotective medication receipt after incident acute coronary syndrome (ACS) among patients with psychotic disorders compared with patients without psychotic disorders. Methods: This was a population-based cohort study with data retrieved from a territory-wide medical record database of public healthcare services to 7.5 million residents in Hong Kong. The study identified 67,692 patients aged ≥18 years admitted for first-recorded ACS between January 1, 2006 and December 31, 2016. The cohort was dichotomously divided by pre-ACS diagnosis of psychotic disorder. Multivariate regression (adjusted odds ratio [aOR] and 95%CI) was used to examine associations of psychotic disorders with all-cause 30-day and 1-year mortality, cardiovascular complications, 30-day and 1-year invasive cardiac procedures, and 90-day post-discharge cardioprotective medication prescription. Results: Patients with psychotic disorders (N=703) had higher 30-day (aOR=1.99, 95%CI=1.65–2.39) and 1-year (aOR=2.13, 95%CI=1.79–2.54) mortality, and cardiovascular complication rates (aOR=1.20, 95%CI=1.02–1.41), lower receipt of cardiac catheterization (30-day: aOR=0.54, 95%CI=0.43–0.68; 1-year: aOR=0.46, 95%CI=0.38–0.56), percutaneous coronary intervention (30-day: aOR=0.55, 95%CI=0.44–0.70; 1-year: aOR=0.52, 95%CI=0.42–0.63) and reduced β-blockers (aOR=0.81, 95%CI=0.68–0.97), statins (aOR=0.54, 95%CI=0.44–0.66), and clopidogrel prescriptions (aOR=0.66, 95%CI=0.55–0.80). Effect of psychotic disorder on heightened mortality was more pronounced in younger-aged (<65 years) and male patients. Associations between psychotic disorder and increased mortality remained significant even after complications and treatment receipt were additionally adjusted. Discussion: Psychotic disorders are associated with increased risks of short-term post-ACS mortality, cardiovascular complications and inferior treatment. Excess mortality is not substantially explained by treatment inequality. Further investigation is warranted to clarify factors for suboptimal cardiac-care and elevated mortality in psychotic disorders to enhance post-ACS outcome.
DescriptionThe Conference was cancelled due to COVID-19
Poster Session I - no. S83
Persistent Identifierhttp://hdl.handle.net/10722/289418
ISSN
2023 Impact Factor: 5.3
2023 SCImago Journal Rankings: 2.249

 

DC FieldValueLanguage
dc.contributor.authorChang, WC-
dc.contributor.authorChan, KN-
dc.contributor.authorWong, SMC-
dc.contributor.authorOr, PCF-
dc.contributor.authorHai, SHJJ-
dc.date.accessioned2020-10-22T08:12:23Z-
dc.date.available2020-10-22T08:12:23Z-
dc.date.issued2020-
dc.identifier.citationSchizophrenia International Research Society (SIRS) Annual Congress 2020, Florence, Italy, 4-8 April 2020. SIRS 2020 Abstracts In Schizophrenia Bulletin, 2020, v. 46 n. S1, p. S65-S66, abstract no. S83-
dc.identifier.issn0586-7614-
dc.identifier.urihttp://hdl.handle.net/10722/289418-
dc.descriptionThe Conference was cancelled due to COVID-19-
dc.descriptionPoster Session I - no. S83-
dc.description.abstractBackground: Ischemic heart disease is the leading cause of premature mortality in psychotic disorders. The authors aimed to examine short-term mortality, cardiovascular complications, revascularization and cardioprotective medication receipt after incident acute coronary syndrome (ACS) among patients with psychotic disorders compared with patients without psychotic disorders. Methods: This was a population-based cohort study with data retrieved from a territory-wide medical record database of public healthcare services to 7.5 million residents in Hong Kong. The study identified 67,692 patients aged ≥18 years admitted for first-recorded ACS between January 1, 2006 and December 31, 2016. The cohort was dichotomously divided by pre-ACS diagnosis of psychotic disorder. Multivariate regression (adjusted odds ratio [aOR] and 95%CI) was used to examine associations of psychotic disorders with all-cause 30-day and 1-year mortality, cardiovascular complications, 30-day and 1-year invasive cardiac procedures, and 90-day post-discharge cardioprotective medication prescription. Results: Patients with psychotic disorders (N=703) had higher 30-day (aOR=1.99, 95%CI=1.65–2.39) and 1-year (aOR=2.13, 95%CI=1.79–2.54) mortality, and cardiovascular complication rates (aOR=1.20, 95%CI=1.02–1.41), lower receipt of cardiac catheterization (30-day: aOR=0.54, 95%CI=0.43–0.68; 1-year: aOR=0.46, 95%CI=0.38–0.56), percutaneous coronary intervention (30-day: aOR=0.55, 95%CI=0.44–0.70; 1-year: aOR=0.52, 95%CI=0.42–0.63) and reduced β-blockers (aOR=0.81, 95%CI=0.68–0.97), statins (aOR=0.54, 95%CI=0.44–0.66), and clopidogrel prescriptions (aOR=0.66, 95%CI=0.55–0.80). Effect of psychotic disorder on heightened mortality was more pronounced in younger-aged (<65 years) and male patients. Associations between psychotic disorder and increased mortality remained significant even after complications and treatment receipt were additionally adjusted. Discussion: Psychotic disorders are associated with increased risks of short-term post-ACS mortality, cardiovascular complications and inferior treatment. Excess mortality is not substantially explained by treatment inequality. Further investigation is warranted to clarify factors for suboptimal cardiac-care and elevated mortality in psychotic disorders to enhance post-ACS outcome.-
dc.languageeng-
dc.publisherOxford University Press. The Journal's web site is located at http://schizophreniabulletin.oxfordjournals.org/-
dc.relation.ispartofSchizophrenia International Research Society (SIRS) Annual Congress 2020-
dc.relation.ispartofSchizophrenia Bulletin-
dc.titleMORTALITY, REVASCULARIZATION AND CARDIOPROTECTIVE PHARMACOTHERAPY AFTER ACUTE CORONARY SYNDROME IN PATIENTS WITH PSYCHOTIC DISORDERS: A POPULATION-BASED COHORT STUDY-
dc.typeConference_Paper-
dc.identifier.emailChang, WC: changwc@hku.hk-
dc.identifier.emailChan, KN: kwunnam@hku.hk-
dc.identifier.emailWong, SMC: wongcsm@hku.hk-
dc.identifier.emailHai, SHJJ: haishjj@hku.hk-
dc.identifier.authorityChang, WC=rp01465-
dc.identifier.authorityWong, SMC=rp02625-
dc.identifier.authorityHai, SHJJ=rp02047-
dc.description.natureabstract-
dc.identifier.doi10.1093/schbul/sbaa031.149-
dc.identifier.hkuros316180-
dc.identifier.volume46-
dc.identifier.issueS1-
dc.identifier.spageS65-
dc.identifier.epageS66-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl0586-7614-

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