Literature DB >> 26820761

Long-term risk of myocardial infarction and stroke in bipolar I disorder: A population-based Cohort Study.

Miguel L Prieto1, Louis A Schenck2, Jennifer L Kruse3, James P Klaas4, Alanna M Chamberlain5, William V Bobo6, Frank Bellivier7, Marion Leboyer8, Véronique L Roger9, Robert D Brown4, Walter A Rocca10, Mark A Frye11.   

Abstract

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.
Copyright © 2016. Published by Elsevier B.V.

Entities:  

Keywords:  Bipolar disorder; Cardiovascular diseases; Cohort studies; Risk

Mesh:

Year:  2016        PMID: 26820761      PMCID: PMC4909505          DOI: 10.1016/j.jad.2016.01.015

Source DB:  PubMed          Journal:  J Affect Disord        ISSN: 0165-0327            Impact factor:   4.839


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