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The association bet...
The association between exposure to clozapine, olanzapine, and quetiapine and the outcomes perimyocarditis and heart failure : A population-based cohort study
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- Clapham, Eric (author)
- Uppsala universitet,Psykiatri,Karolinska Univ Hosp, Karolinska Inst, Ctr Pharmacoepidemiol CPE, Dept Med Solna, Stockholm, Sweden.
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- Reutfors, Johan (author)
- Karolinska Univ Hosp, Karolinska Inst, Ctr Pharmacoepidemiol CPE, Dept Med Solna, Stockholm, Sweden.
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- Linder, Marie (author)
- Karolinska Institutet
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- Brandt, Lena (author)
- Karolinska Univ Hosp, Karolinska Inst, Ctr Pharmacoepidemiol CPE, Dept Med Solna, Stockholm, Sweden.
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- Sundström, Johan, Professor, 1971- (author)
- Uppsala universitet,Klinisk epidemiologi,Univ New South Wales, George Inst Global Hlth, Sydney, Australia.
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- Bodén, Robert, 1973- (author)
- Uppsala universitet,Psykiatri
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(creator_code:org_t)
- Elsevier, 2023
- 2023
- English.
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In: Psychiatry Research. - : Elsevier. - 0165-1781 .- 1872-7123. ; 326
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https://doi.org/10.1...
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https://uu.diva-port... (primary) (Raw object)
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Abstract
Subject headings
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- The risk of cardiac adverse events following clozapine use is debated and is unknown for the chemically related and widely used antipsychotics olanzapine and quetiapine. National Swedish registers were used to identify all patients 16-75 years old with antipsychotic dispensations between 2005 and 2018. The short-term outcome was a diagnosis of perimyocarditis (pericarditis and/or myocarditis) within two months of first dispensation, and the long-term outcome was heart failure (including cardiomyopathy) within three years. Cox regressions with time varying exposure were used to estimate hazard rates (HR) and their 95% confidence intervals (CI). A total of 201,045 individuals were included in the cohort. The risk of developing perimyocarditis during clozapine treatment tripled compared to no antipsychotic treatment (HR 3.4, CI 1.6-7.3), although the absolute rate remained comparably low. The long-term risk of heart failure during clozapine treatment was also elevated (HR 1.3, CI 1.1-1.7). Treatment with either or both olanzapine or quetiapine was not associated with an increased relative risk of perimyocarditis, or heart failure compared to no antipsychotic treatment. Clozapine use is therefore associated with a substantially elevated short-term risk of perimyocarditis and an increased risk of heart failure within three years.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Psykiatri (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Psychiatry (hsv//eng)
Keyword
- Antipsychotics
- Clozapine
- Cardiac adverse events
- Myocarditis
- Pericarditis
- Cardiomyopathy
Publication and Content Type
- ref (subject category)
- art (subject category)
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