Adverse cardiac events in out-patients initiating clozapine treatment: a nationwide register-based study.
Acta Psychiatr Scand
; 137(1): 47-53, 2018 Jan.
Article
em En
| MEDLINE
| ID: mdl-29064084
ABSTRACT
OBJECTIVE:
Using national Danish registers, we estimated rates of clozapine-associated cardiac adverse events. Rates of undiagnosed myocarditis were estimated by exploring causes of death after clozapine initiation.METHOD:
Through nationwide health registers, we identified all out-patients initiating antipsychotic treatment (January 1, 1996-January 1, 2015). Rates of clozapine-associated myocarditis and pericarditis within 2 months from clozapine initiation and rates of cardiomyopathy within 1-2 years from clozapine initiation were compared to rates for other antipsychotics. Mortality within 2 months from clozapine initiation was extracted.RESULTS:
Three thousand two hundred and sixty-two patients of a total 7932 patients initiated clozapine as out-patients (41.12%). One patient (0.03%) developed myocarditis, and no patients developed pericarditis within 2 months from clozapine initiation. Two (0.06%) and four patients (0.12%) developed cardiomyopathy within 1 and 2 years respectively. Rates were similar for other antipsychotics. Twenty-six patients died within 2 months from clozapine initiation. Pneumonia (23.08%) and stroke (11.54%) were the main causes of death. We estimated the maximum rate of clozapine-associated fatal myocarditis to 0.28%.CONCLUSION:
Cardiac adverse effects in Danish out-patients initiating clozapine treatment are extremely rare and these rates appear to be comparable to those observed for other antipsychotic drugs.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Pericardite
/
Transtornos Psicóticos
/
Esquizofrenia
/
Antipsicóticos
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Transtorno Bipolar
/
Sistema de Registros
/
Clozapina
/
Cardiomiopatias
/
Miocardite
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article