Abstract 14811: Psychiatric Disorders, Drug Therapy and Risk of SCD in the Community
Background: Previous studies have reported associations between schizophrenia, psychotropic drugs, anti-depressants and the risk of sudden cardiac death (SCD) but risk conferred by the condition has not been clear separated from the risk posed by drugs. We hypothesized that psychiatric disorders and specific drug therapies have independent effects on risk of SCD in the general population.
Methods: SCD cases and controls age ≥18 yrs were identified from an ongoing prospective evaluation of SCD in the northwest US (approximately 1 million population, 2002-2012). Analysis was limited to subjects with medical records available for review. Comparison of psychosocial history (depression, anxiety, bipolar disorder, post-traumatic stress disorder, and schizophrenia) and psychotropic/anti-depressant drugs were evaluated using Pearson’s chi-square tests and independent samples t-tests.
Results: A total of 1750 cases and 793 controls were evaluated. There were no significant differences in mean age and gender distribution (p≥0.08). Compared to controls, schizophrenia was more common in cases (2.4 vs. 0.5%, p=0.0009) regardless of gender (p=0.02). There were no significant differences with regard to other psychiatric disorders (p≥0.14). Use of antipsychotic (8.4 vs. 2.0%, p<0.0001) and antidepressant (29.9 vs. 25.0%, p=0.02) medications were more common in cases, regardless of gender. In a logistic regression model adjusted for age and gender, use of anti-psychotic medications was a significant predictor of SCD (OR 3.74, 95% CI 2.12 - 6.61), while schizophrenia was not significantly associated with SCD (OR 2.03, 95% CI 0.68 - 6.08).
Conclusions: Use of anti-psychotic medications was independently associated with the risk of SCD, adjusting for age, gender, documented schizophrenia, documented depression, and use of anti-depressants. No associations were identified for other psychiatric disorders and medications.
- © 2012 by American Heart Association, Inc.