Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Association Between ECG Abnormalities and Fatal Cardiovascular Disease Among Patients With and Without Severe Mental Illness

Research output: Contribution to journalJournal articleResearchpeer-review

DOI

  1. Abnormal Left-Hemispheric Sulcal Patterns in Adults With Simple Congenital Heart Defects Repaired in Childhood

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Functional Capacity Past Age 40 in Patients With Congenital Ventricular Septal Defects

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Long-Term Results After Drug-Eluting Versus Bare-Metal Stent Implantation in Saphenous Vein Grafts: Randomized Controlled Trial

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Impact of Interatrial Shunts on Invasive Hemodynamics and Exercise Tolerance in Patients With Heart Failure

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Congenital Heart Disease and Risk of Suicide and Self-Harm: A Danish Nationwide Cohort Study

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Christoffer Polcwiartek
  • Brett D Atwater
  • Kristian Kragholm
  • Daniel J Friedman
  • Carlo A Barcella
  • Rubina Attar
  • Claus Graff
  • Jonas B Nielsen
  • Adrian Pietersen
  • Peter Søgaard
  • Christian Torp-Pedersen
  • Svend E Jensen
View graph of relations

Background ECG abnormalities are associated with adverse outcomes in the general population, but their prognostic significance in severe mental illness (SMI) remains unexplored. We investigated associations between no, minor, and major ECG abnormalities and fatal cardiovascular disease (CVD) among patients with SMI compared with controls without mental illness. Methods and Results We cross-linked data from Danish nationwide registries and included primary care patients with digital ECGs from 2001 to 2015. Patients had SMI if they were diagnosed with schizophrenia, bipolar disorder, or severe depression before ECG recording. Controls were required to be without any prior mental illness or psychotropic medication use. Fatal CVD was assessed using hazard ratios (HRs) with 95% CIs and standardized 10-year absolute risks. Of 346 552 patients, 10 028 had SMI (3%; median age, 54 years; male, 45%), and 336 524 were controls (97%; median age, 56 years; male, 48%). We observed an interaction between SMI and ECG abnormalities on fatal CVD (P<0.001). Severe mental illness was associated with fatal CVD across no (HR, 2.17; 95% CI, 1.95-2.43), minor (HR, 1.90; 95% CI, 1.49-2.42), and major (HR, 1.40; 95% CI, 1.26-1.55) ECG abnormalities compared with controls. Across age- and sex-specific subgroups, SMI patients with ECG abnormalities but no CVD at baseline had highest standardized 10-year absolute risks of fatal CVD. Conclusions ECG abnormalities conferred a poorer prognosis among patients with SMI compared with controls without mental illness. SMI patients with ECG abnormalities but no CVD represent a high-risk population that may benefit from greater surveillance and risk management.

Original languageEnglish
Article numbere019416
JournalJournal of the American Heart Association
Volume10
Issue number2
Pages (from-to)1-11
Number of pages11
ISSN2047-9980
DOIs
Publication statusPublished - 19 Jan 2021

    Research areas

  • ECG, Primary care, Risk prediction, Severe mental illness

ID: 61789236