| アブストラクト | Initiating aripiprazole as antipsychotic monotherapy rather than olanzapine, quetiapine, or risperidone, might prevent/delay major adverse cardiovascular events (MACEs) over the long-term in people diagnosed with severe mental illness. Using Clinical Practice Research Datalink data, we emulated a trial of aripiprazole versus olanzapine, quetiapine, and risperidone in 20,404 patients 2005-2014. Primary outcome was five-year MACE risk (composite of hospitalisation for acute myocardial infarction or stroke and cardiovascular death). Here we show that patients initiating aripiprazole had a similar five-year MACE risk as those initiating olanzapine (risk ratio: 1.03, 95% CI, 0.78-1.32), quetiapine (1.02, 95% CI, 0.72-1.32), and risperidone (0.88, 95% CI, 0.67-1.17). Risk was lower among patients initiating and continuing aripiprazole versus risperidone (0.58, 95% CI, 0.39-0.84). For patients at clinical equipoise, antipsychotic selection does not appear to significantly impact risk of the most severe, long-term cardiovascular events. However, further research is needed to replicate our finding of increased risk with continued risperidone use versus aripiprazole. |
|---|
| ジャーナル名 | Nature communications |
|---|
| Pubmed追加日 | 2025/12/22 |
|---|
| 投稿者 | Richards-Belle, Alvin; Launders, Naomi; Hardoon, Sarah; Man, Kenneth K C; Davies, Neil M; Bramon, Elvira; Hayes, Joseph F; Osborn, David P J |
|---|
| 組織名 | Division of Psychiatry, University College London, Maple House, London, UK.;alvin.richards-belle@ucl.ac.uk.;Research Department of Practice and Policy, School of Pharmacy, University;College London, London, UK.;Centre for Medicines Optimisation Research and Education, University College;London Hospitals NHS Foundation Trust, London, UK.;Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine,;University of Hong Kong, Hong Kong, China.;Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Hong;Kong, China.;Department of Statistical Sciences, University College London, London, UK.;Department of Public Health and Nursing, Norwegian University of Science and;Technology, Trondheim, Norway.;North London NHS Foundation Trust, London, UK. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/41423548/ |
|---|
