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Unrecognised myocardial infarction in patients with schizophrenia

Published online by Cambridge University Press:  13 January 2015

Jimmi Nielsen ,
Jacob Juel ,
Karam Sadoon Majeed Al Zuhairi ,
Rasmus Friis ,
Claus Graff ,
Jørgen Kim Kanters  and
Svend Eggert Jensen
Jimmi Nielsen*
Affiliation:
Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
Jacob Juel
Affiliation:
Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
Karam Sadoon Majeed Al Zuhairi
Affiliation:
Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
Rasmus Friis
Affiliation:
Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark
Claus Graff
Affiliation:
Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
Jørgen Kim Kanters
Affiliation:
Laboratory of Experimental Cardiology, Department of Biomedical Sciences, Copenhagen University, København, Denmark Department of Cardiology, Herlev & Gentofte University Hospitals, Copenhagen, Denmark
Svend Eggert Jensen
Affiliation:
Department of Clinical Medicine, Aalborg University, Aalborg, Denmark Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
*
Jimmi Nielsen, Centre for Schizophrenia, Aalborg University Hospital, Psychiatry, Brandevej 5, 9220 Aalborg Øst, Denmark. Tel: +4597643565; Fax: +4597643566; E-mail: jin@rn.dk
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Abstract

Objective

Schizophrenia is associated with a reduction of the lifespan by 20 years, with type II diabetes and cardiovascular disease contributing the most to the increased mortality. Unrecognised or silent myocardial infarction (MI) occurs in ~30% of the population, but the rates of unrecognised MI in patients with schizophrenia have only been sparsely investigated.

Method

Electrocardiograms (ECG) from three psychiatric hospitals in Denmark were manually interpreted for signs of previous MI. Subsequently, ECGs were linked to the National Patient Registry in order to determine whether patients had a diagnosis consistent with previous MI.

Results

A total of 937 ECGs were interpreted, 538 men (57.4%) and 399 women (42.6%). Mean age at the time of ECG acquisition was 40.6 years (95% CI: 39.7–41.5, range: 15.9–94.6). We identified 32 patients with positive ECG signs of MIs. Only two of these patients had a diagnosis of MI in the National Patient Registry. An additional number of eight patients had a diagnosis of MI in the Danish National Patient Registry, but with no ECG signs of previous MI. This means that 30 out of 40 (75%) MIs were unrecognised. Only increasing age was associated with unrecognised MI in a stepwise multiple logistic regression model compared with patients with no history of MI, OR: 1.03 per year of age, 95% CI: 1.00–1.06, p=0.021.

Conclusion

Unrecognised MI is common among patients with schizophrenia and may contribute to the increased mortality found in this patient group.

Keywords

AMImortalitypain perceptionpsychosis
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 27 , Issue 2 , April 2015 , pp. 106 - 112
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Copyright
© Scandinavian College of Neuropsychopharmacology 2015 

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