TY - JOUR
T1 - Long-term risk of myocardial infarction and stroke in bipolar i disorder
T2 - A population-based Cohort Study
AU - Prieto, Miguel L.
AU - Schenck, Louis A.
AU - Kruse, Jennifer L.
AU - Klaas, James P.
AU - Chamberlain, Alanna M.
AU - Bobo, William V.
AU - Bellivier, Frank
AU - Leboyer, Marion
AU - Roger, Véronique L.
AU - Brown, Robert D.
AU - Rocca, Walter A.
AU - Frye, Mark A.
N1 - Funding Information:
This project was made possible by the Rochester Epidemiology Project (Grant number R01-AG034676 ; from the National Institute on Aging [NIA]). It was partially supported by Grant UL1-TR000135 from the National Center for Advancing Translational Sciences (NCATS). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. It was partially supported by Mayo Foundation for Medical Education and Research , the Marriott Foundation and the Government of Chile (CONICYT Becas Chile Grant number 73130844) .
Funding Information:
Dr. Frye has been a consultant (unpaid) for Allergan, Merck, Myriad, Sanofi-Aventis, Sunovion, Takeda Global Research, Teva Pharmaceuticals, United Biosource Corporation, has received grant support from Myriad, Pfizer, National Alliance for Schizophrenia and Depression (NARSAD), National Institute of Mental Health (NIMH), National Institute of Alcohol Abuse and Alcoholism (NIAAA), Mayo Foundation, and has received travel support from the Chilean Society of Neurology, Psychiatry and Neurosurgery (Sociedad de Neurologia, Psiquiatria y Neurocirugia), Advanced Health Media, GlaxoSmithKline, Colombian Society of Neuropsychopharmacology, AstraZeneca, Bristol-Myers-Squib, Otsuka, Sanofi-Aventis.
Funding Information:
We thank Merle J. Belz, RN, Cynthia L. Nosek, RN, and Cynthia J. Stoppel, BS for their work abstracting the medical records, Jennifer St. Sauver, PhD for her advice on the Rochester Epidemiology Project, and Renato D. Alarcón, MD, MPH, Timothy W. Lineberry, MD, and Glenn E. Smith, PhD for their advice and support to this project.
Publisher Copyright:
© 2016 Published by Elsevier B.V.
PY - 2016/4/1
Y1 - 2016/4/1
N2 - Objectives To estimate the risk of fatal and non-fatal myocardial infarction (MI) and stroke in patients with bipolar I disorder compared to people without bipolar I disorder. Method Utilizing a records-linkage system spanning 30 years (1966-1996), a population-based cohort of 334 subjects with bipolar I disorder and 334 age and sex-matched referents from Olmsted County, Minnesota, U.S. was identified. Longitudinal follow-up continued until incident MI or stroke (confirmed by board-certified cardiologist/neurologist), death, or study end date (December 31, 2013). Cox proportional hazards models assessed the hazard ratio (HR) for MI or stroke, adjusting for potential confounders. Results There was an increased risk of fatal or non-fatal MI or stroke (as a composite outcome) in patients with bipolar I disorder [HR 1.54, 95% confidence interval (CI) 1.02, 2.33; p=0.04]. However, after adjusting for baseline cardiovascular risk factors (alcoholism, hypertension, diabetes, and smoking), the risk was no longer significantly increased (HR 1.19, 95% CI 0.76, 1.86; p=0.46). Limitations Small sample size for the study design. Findings were not retained after adjustment for cardiovascular disease risk factors. Psychotropic medication use during the follow-up was not ascertained and was not included in the analyses. Conclusion This study in a geographically defined region in the U.S. demonstrated a significant increased risk of MI or stroke in bipolar I disorder, which was no longer significant after adjustment for cardiovascular risk factors.
AB - Objectives To estimate the risk of fatal and non-fatal myocardial infarction (MI) and stroke in patients with bipolar I disorder compared to people without bipolar I disorder. Method Utilizing a records-linkage system spanning 30 years (1966-1996), a population-based cohort of 334 subjects with bipolar I disorder and 334 age and sex-matched referents from Olmsted County, Minnesota, U.S. was identified. Longitudinal follow-up continued until incident MI or stroke (confirmed by board-certified cardiologist/neurologist), death, or study end date (December 31, 2013). Cox proportional hazards models assessed the hazard ratio (HR) for MI or stroke, adjusting for potential confounders. Results There was an increased risk of fatal or non-fatal MI or stroke (as a composite outcome) in patients with bipolar I disorder [HR 1.54, 95% confidence interval (CI) 1.02, 2.33; p=0.04]. However, after adjusting for baseline cardiovascular risk factors (alcoholism, hypertension, diabetes, and smoking), the risk was no longer significantly increased (HR 1.19, 95% CI 0.76, 1.86; p=0.46). Limitations Small sample size for the study design. Findings were not retained after adjustment for cardiovascular disease risk factors. Psychotropic medication use during the follow-up was not ascertained and was not included in the analyses. Conclusion This study in a geographically defined region in the U.S. demonstrated a significant increased risk of MI or stroke in bipolar I disorder, which was no longer significant after adjustment for cardiovascular risk factors.
KW - Bipolar disorder
KW - Cardiovascular diseases
KW - Cohort studies
KW - Risk
KW - Bipolar disorder
KW - Cardiovascular diseases
KW - Cohort studies
KW - Risk
UR - http://www.scopus.com/inward/record.url?scp=84955447533&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2016.01.015
DO - 10.1016/j.jad.2016.01.015
M3 - Article
C2 - 26820761
AN - SCOPUS:84955447533
SN - 0165-0327
VL - 194
SP - 120
EP - 127
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
ER -
