| アブストラクト | AIM: Antipsychotics increase the risk of stroke. Their effect on myocardial infarction remains uncertain because people prescribed and not prescribed antipsychotic drugs differ in their underlying vascular risk making between-person comparisons difficult to interpret. The aim of our study was to investigate this association using the self-controlled case series design that eliminates between-person confounding effects. METHODS AND RESULTS: All the patients with a first recorded myocardial infarction and prescription for an antipsychotic identified in the Clinical Practice Research Datalink linked to the Myocardial Ischaemia National Audit Project were selected for the self-controlled case series. The incidence ratio of myocardial infarction during risk periods following the initiation of antipsychotic use relative to unexposed periods was estimated within individuals. A classical case-control study was undertaken for comparative purposes comparing antipsychotic exposure among cases and matched controls. We identified 1546 exposed cases for the self-controlled case series and found evidence of an association during the first 30 days after the first prescription of an antipsychotic, for first-generation agents [incidence rate ratio (IRR) 2.82, 95% confidence interval (CI) 2.0-3.99] and second-generation agents (IRR: 2.5, 95% CI: 1.18-5.32). Similar results were found for the case-control study for new users of first- (OR: 3.19, 95% CI: 1.9-5.37) and second-generation agents (OR: 2.55, 95% CI: 0.93-7.01) within 30 days of their myocardial infarction. CONCLUSION: We found an increased risk of myocardial infarction in the period following the initiation of antipsychotics that was not attributable to differences between people prescribed and not prescribed antipsychotics. |
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| ジャーナル名 | European heart journal |
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| 投稿日 | 2014/7/10 |
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| 投稿者 | Brauer, Ruth; Smeeth, Liam; Anaya-Izquierdo, Karim; Timmis, Adam; Denaxas, Spiros C; Farrington, C Paddy; Whitaker, Heather; Hemingway, Harry; Douglas, Ian |
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| 組織名 | Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and;Population Health, London School of Hygiene and Tropical Medicine, Keppel Street,;London WC1E 7HT, UK ruth.brauer@lshtm.ac.uk.;London WC1E 7HT, UK.;Department of Infectious Disease Epidemiology, Faculty of Epidemiology and;National Institute for Health Research Biomedical Research Unit, Barts Health,;London, UK.;Department of Epidemiology and Public Health, Clinical Epidemiology, University;College London, 1-19 Torrington Place, London WC1E 7HB, UK.;Department of Statistics, The Open University, Milton Keynes MK7 6BJ, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25005706/ |
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