Schizophrenia patients at increased death risk after AMI

By Mark Cowen, Senior medwireNews Reporter

Results from a Canadian study show that patients with schizophrenia are significantly more likely to die after acute myocardial infarction (AMI) than other patients.

The team found that the risk for mortality within 30 days of discharge after an AMI was more than 50% greater among patients with schizophrenia than other patients.

In addition, schizophrenia patients who had experienced an AMI were less likely than other AMI patients to see a cardiologist or undergo cardiac procedures after discharge.

"The higher mortality and higher baseline comorbidities suggest that individuals with schizophrenia should be more, not less, likely to receive life-saving interventions and expert care following AMI," comment Paul Kurdyak (Centre for Addiction and Mental Health, Toronto, Ontario) and colleagues.

The team studied 30-day follow-up data on 71,668 incident AMI patients, aged at least 20 years, after discharge from hospital. Of these, 842 had a diagnosis of schizophrenia.

After accounting for age, gender, rural/urban residence, income, length of hospital stay, frequency of primary care visits, medical comorbidities, and other variables, the researchers found that schizophrenia patients were 1.56 times more likely to die within 30 days of discharge than other AMI patients.

Schizophrenia patients were also 47% less likely to see a cardiologist during the follow-up period than other AMI patients, and 52% less likely to undergo cardiac procedures, such as coronary artery bypass graft surgery or percutaneous transluminal coronary angiography.

Indeed, just 12.2% of schizophrenia patients had follow-up with a cardiologist after discharge and only 24.1% received a cardiac procedure, compared with a respective 20.1% and 37.9% of patients without schizophrenia.

Kurdyak and team summarize in Schizophrenia Research: "Individuals with schizophrenia are at greater risk of dying after incident AMI than individuals without schizophrenia. Despite this elevated mortality risk, they are also less likely to receive cardiac procedures and specialist care following incident AMI."

They add: "Further research is required to expose the mechanisms explaining both the elevated mortality and health service use disparities observed in this vulnerable population."

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