期刊
EUROPEAN HEART JOURNAL
卷 33, 期 6, 页码 745-751出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehr368
关键词
Myocardial infarction; Psychiatric disorder; Sudden death
资金
- Sigrid Juselius Foundation, Helsinki, Finland
- Foundation Leducq, Paris, France
Psychotropic medication increases cardiac mortality, but the reasons for this association are not clear. We studied the role of psychotropic drugs as a triggering factor of sudden cardiac death (SCD) during an acute coronary event. The use of medication was compared between victims of SCD and survivors of an acute coronary event in a casecontrol study including a consecutive series of victims of SCD (n 1814, mean age 65 11 years) verified to be due to an acute coronary event at medico-legal autopsy and consecutive series of patients surviving an acute myocardial infarction (AMI; n 1171, mean age 66 12 years). The medication history was obtained from autopsy/hospital records and interviews with relatives of SCD victims and AMI patients. The use of antipsychotics [9.7 vs. 2.4, odds ratio (OR) 4.4, 95 confidence interval (CI) 2.96.6; P 0.001] and antidepressants (8.6 vs. 5.5, OR: 1.6, 95 CI: 1.22.2; P 0.003) was more common in the SCD than AMI group, but the use of benzodiazepines did not differ between the groups (11.7 vs. 13.2; P 0.270). The use of antipsychotics remained as a significant risk factor for SCD after adjustment for confounding variables (OR: 3.4, 95 CI: 1.86.5; P 0.001). Combined use of phenothiazines and any antidepressant was associated with a very high risk of SCD (OR: 18.3, 95 CI: 2.5135.3; P 0.001). The use of psychotropic drugs, especially combined use of antipsychotic and antidepressant drugs, is strongly associated with an increased risk of SCD at the time of an acute coronary event.
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