Certain Antipsychotics May Up CV Risk in Older Patients

A total of 1,008 outpatients over the age of 30 were included in the studies analysis
A total of 1,008 outpatients over the age of 30 were included in the studies analysis

Researchers from Buenos Aires, Argentina reported that older adults receiving antipsychotic therapy with high- or intermediate- risk of metabolic side effects may have an increased incidence of major cardiovascular events vs. patients receiving a low-risk regimen. Findings from the retrospective cohort study are published in The Journal of Clinical Psychiatry.

Lead author, Alejandro G. Szmulewicz, MD, and colleagues grouped the antipsychotic drugs based on the severity of their metabolic side effect profiles (ie, low, intermediate, or high risk of major cardiovascular events).

The study included 1,008 outpatients aged ≥30 years starting antipsychotics from 2002–2007. The primary outcome was time to the composite of acute myocardial infarction, acute coronary syndrome, ischemic stroke, peripheral artery disease, or new revascularization procedure. 

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Of the total patients, 19.6% experienced the primary outcome. After adjusting for confounding, the hazard ratios of a major cardiovascular event for patients was  2.82 (95% CI: 1.57–5.05) in the high-risk medication group, and 2.57 (95% CI: 1.43–4.63) in the intermediate-risk medication group, as compared to the low-risk medication group. 

"This finding appears to be mostly driven by the enhanced risk of stroke among our population, something that might be due to the high prevalence of patients with dementia in our sample or related to potential direct or indirect effects of antipsychotics," the authors concluded. 

For more information visit psychiatrist.com.