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Br J Clin Pharmacol. 2016 Sep;82(3):624-32. doi: 10.1111/bcp.12985. Epub 2016 May 23.

Use of antipsychotics and risk of myocardial infarction: a systematic review and meta-analysis.

Author information

1
Department of Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, 310013, PR China.
2
Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, 310003, China.
3
Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, 410011.
4
Department of Child Psychiatry, Hangzhou Seventh People's Hospital, Hangzhou, 310013, PR China.

Abstract

AIM:

There is emerging concern that antipsychotics may be associated with an increased risk of myocardial infarction (MI). A previous review identified five observational studies that did not provide an accurate estimate of the association between antipsychotic drug use and MI risk. More recent studies have produced variable results.

METHODS:

We performed a systematic review and meta-analysis of observational studies to determine whether antipsychotic use affects the risk for MI. Our analysis included all observational studies that compared MI incidence among patients receiving antipsychotics vs. no treatment.

RESULTS:

Nine observational studies were included in the analysis. The odds for developing MI were 1.88-fold higher (odds ratio (OR) 1.88, 95% confidence interval (CI) 1.39, 2.54) in antipsychotic users compared with individuals who had not taken antipsychotics. Subgroup analyses found an OR of 2.48 (95% CI 1.66, 3.69) among patients with schizophrenia and an OR of 2.64 (95% CI 2.48, 2.81) among short term (<30 days) antipsychotic users.

CONCLUSION:

The findings of this meta-analysis support an increased risk of MI in antipsychotic drug users. The present systematic review expands previous knowledge by demonstrating an increased and more pronounced risk in short term users.

KEYWORDS:

antipsychotic agents; coronary disease; myocardial infarction

PMID:
27198162
PMCID:
PMC5338104
DOI:
10.1111/bcp.12985
[Indexed for MEDLINE]
Free PMC Article

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