Severe Mental Illness Linked to Increased Mortality Post-MI
(HealthDay News) — Patients with severe mental illness (SMI) have increased mortality after myocardial infarction, according to a study published online November 17 in the Journal of Internal Medicine.
Robert Bodén, MD, PhD, from Uppsala University in Sweden, and colleagues examined the impact of SMI on myocardial infarction survival in a population-based cohort study. Data were included for all 209,592 patients with a first diagnosis of myocardial infarction in the Swedish nationwide myocardial infarction register from 1997–2010. Exposure was defined as a diagnosis of SMI (i.e., bipolar disorder or schizophrenia) prior to infarction.
The researchers found that the 442 patients with bipolar disorder and 541 with schizophrenia were younger than those without SMI (mean age 68 and 63 years, respectively, vs. 71 years). The overall 30-day mortality rate was 10% and the one-year mortality rate was 18%. In the fully adjusted model, patients with SMI had elevated 30-day mortality and one-year mortality (odds ratios, 1.99 and 2.11, respectively) compared with patients without SMI. Patients with schizophrenia had the highest mortality (odds ratios, 2.58 and 2.55 for 30-day and one-year mortality, respectively).
"SMI is associated with a marked higher mortality after myocardial infarction, even after accounting for contributing factors," the authors write. "It is imperative to identify the reasons for this higher mortality."