Kugathasan P, et al. - Researchers performed this Danish nationwide cohort study of patients with myocardial infarction to investigate if cardioprotective medication use after myocardial infarction is associated with reduced mortality rates among patients with schizophrenia. According to findings, there may be an excess mortality rate among patients with schizophrenia who did not receive cardioprotective medication; however, reduced mortality was evident in association with exposure to medication.

Methods

• Individuals admitted with first-time myocardial infarction in Denmark from January 1, 1995, to December 31, 2015, were included.
• Researchers divided the cohort dichotomously by a diagnosis of schizophrenia.
• The nationwide registries were used for obtaining data on the prescription of guideline-recommended cardioprotective medication, including anti-thrombotics, β-blockers, vitamin K antagonist, angiotensin-converting enzyme inhibitors, and statins.
• Using Cox proportional hazards regression, they calculated hazard ratios (HRs) with 95% CIs for the association between treatment exposure and all-cause mortality after myocardial infarction between patients with and without schizophrenia.

Results

• Researchers included 105,018 patients with myocardial infarction; among these, 684 patients had schizophrenia and 104,334 were general population patients.
• A total follow-up of 796,435 person-years was performed, and 28,059 deaths were reported.
• They noted the highest mortality rate among patients with schizophrenia who did not receive cardioprotective treatment (HR, 8.78; 95% CI, 4.37-17.64) vs the general population treated; treated patients with schizophrenia had an increased HR of 1.97 (95% CI, 1.25-3.10).
• On analyzing the associations of different cardiac therapy strategies with mortality rates in the multivariable analysis, they noted that patients with schizophrenia who were treated with any combination of triple therapy had mortality rates similar to those observed in the general population (HR, 1.05; 95% CI, 0.43-2.52).