Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study
Open accessAbstract
Objective Persons with schizophrenia die earlier than the general population, in large part due to cardiovascular disease. The study objective was to examine effects of different antipsychotic treatments on estimates of 10-year coronary heart disease (CHD) risk calculated by the Framingham Heart Study formula.Method Change in 10-year risk for CHD was compared between treatment groups in 1125 patients followed for 18 months or until treatment discontinuation in the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Schizophrenia Trial.Results The covariate-adjusted mean change in 10-year CHD risk differed significantly between treatments. Olanzapine was associated with a 0.5% (SE 0.3) increase and quetiapine, a 0.3% (SE 0.3) increase; whereas risk decreased in patients treated with perphenazine, -0.5% (SE 0.3), risperidone, -0.6% (SE 0.3), and ziprasidone -0.6% (SE 0.4). The difference in 10-year CHD risk between olanzapine and risperidone was statistically significant (p=0.004). Differences in estimated 10-year CHD risk between drugs were most marked in the tertile of subjects with a baseline CHD risk of at least 10%. Among individual CHD risk factors used in the Framingham formula, only total and HDL cholesterol levels differed between treatments.Conclusions These results indicate that the impact on 10-year CHD risk differs significantly between antipsychotic agents, with olanzapine producing the largest elevation in CHD risk of the agents studied in CATIE.
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Daumit et al. 2008 found treatment with olanzapine and quetiapine was associated with higher long-term risk of cardiovascular disease than treatment with perphenazin, risperidone, and ziprasidone.
“Daumit et al. (2008) analyzed changes in 10-year coronary heart disease risk estimates during the 18-month CATIE trial by antipsychotic treatment, and they found that treatment with olanzapine and quetiapine was associated with a higher long-term risk of cardiovascular disease than was treatment with perphenazin, risperidone, and ziprasidone.”
From Excess early mortality in schizophrenia. (2014) · cites this paper as Daumit et al. 2008
Several factors contribute to the early and frequent development of cardiovascular disease in this population, including genetic vulnerability, metabolic adverse effects of antipsychotics, insufficient treatment of somatic comorbidity, and unhealthy lifestyle.
“Several factors contribute to the early and frequent development of cardiovascular disease in this population, including genetic vulnerability 5 , metabolic adverse effects of antipsychotics 6,7 , insufficient treatment of somatic comorbidity 8 , and unhealthy lifestyle 9 .”
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- Authors
- Daumit, G. L., Goff, D. C., Meyer, J. M., Davis, V. G., Nasrallah, H. A., McEvoy, J. P., Rosenheck, R., Davis, S. M., Hsiao, J. K., Stroup, T. S., & Lieberman, J. A.
- Affiliations
- Johns Hopkins University (US)
- Harvard University (US)
- University of California San Diego (US)
- Bank of America (US)
- University of Cincinnati (US)
- Duke University (US)
- Yale University (US)
- National Institutes of Health (US)
- University of North Carolina at Chapel Hill (US)
- Columbia University (US)
- Corresponding author
- Daumit, Gail L.
- ORCID
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2008-10
- Volume
- 105
- Issue
- 1-3
- Pages
- 175-187
- ISSN
- 0920-9964 (ISSN-L)
- PMC
- PMC2614656
- OpenAlex
- W2107325590
- Cited by
- 223
- References
- 44
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 8 · 2023: 2 · 2022: 6 · 2021: 9 · 2020: 6 · 2019: 11 · 2018: 11 · 2017: 13 · 2016: 10 · 2015: 20 · 2014: 16 · 2013: 24 · 2012: 20
- FWCI
- 14.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Schizophrenia Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (1MH900001)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Keywords
- antipsychotic drugs, coronary heart disease risk
- MeSH terms
- Adult, Coronary Disease, Female, Follow-Up Studies, Humans, Hypertension, Longitudinal Studies, Male, Obesity, Patient Dropouts, Risk Factors, Schizophrenia, Schizophrenic Psychology, Smoking, Antipsychotic Agents, Weight Gain, Comorbidity, Treatment Outcome, Outcome Assessment, Health Care, Risk Assessment
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