Cardiovascular and metabolic risk in outpatients with schizoaffective disorder treated with antipsychotics: Results from the CLAMORS study

Aim: To assess the coronary heart disease (CHD) risk and prevalence of the metabolic syndrome (MS) in patients with schizoaffective disorder (SD) receiving antipsychotics. Methods: Patients meeting DSM-IV criteria for SD and receiving antipsychotic treatment were recruited in a retrospective, cross-sectional, multicenter study (the CLAMORS study). MS was defined as at least three of the following components: waist circumference greater than 102 cm (men)/greater than 88 cm (women); serum triglycerides greater or equal to 150 mg/dl; HDL cholesterol less than 40 mg/dl (men)/less than 50 mg/dl (women); blood pressure greater or equal to 130/85 mmHg; fasting blood glucose greater or equal to 110 mg/dl. The 10-year CHD risk was assessed by the Systematic coronary risk evaluation (SCORE) (cardiovascular mortality) and Framingham (any cardiovascular event) functions. Clinical severity was assessed using the PANSS and CGI-S scales. Results: A total of 268 valuable patients with SD (127 men, 48.1%), 41.9 +/- 12.3 years (mean +/- S. D.), were analyzed. The 10-year overall cardiovascular mortality and CV-event risk were 0.8 +/- 1.6 (SCORE) and 6.5 +/- 6.8 (Framingham), respectively. A high/very high risk of any CV event (Framingham >= 10%) was associated with severity [CGI-S = 3-4; OR: 4.32 (1.15-16.26), P = 0.03)]. MS was present in 26.5% (95% CI: 21.2-31.8) of subjects, without gender differences, but significantly associated with patient's impression of severity: CGI = 3-4; OR = 1.90 (0.83-4.36), and CGI = 5-7; OR = 3.13 (1.06-9.24), P = 0 < 0.001, and age [OR = 1.91 (1.09-3.34), P < 0.024)]. Conclusions: CHD risk and MS prevalence were high among patients with SD, being MS prevalence associated with age and severity of disease. (C) 2010 Elsevier Masson SAS. All rights reserved.