Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study

Gail L. Daumit, Donald C. Goff, Jonathan M. Meyer, Vicki G. Davis, Henry A. Nasrallah, Joseph Patrick McEvoy, Robert Rosenheck, Sonia M. Davis, John K. Hsiao, T. Scott Stroup, Jeffrey A. Lieberman

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Abstract

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.

Original languageEnglish (US)
Pages (from-to)175-187
Number of pages13
JournalSchizophrenia Research
Volume105
Issue number1-3
DOIs
StatePublished - Oct 1 2008

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Antipsychotic Agents
Coronary Disease
Schizophrenia
Clinical Trials
olanzapine
Risperidone
Perphenazine
Therapeutics
HDL Cholesterol
Cardiovascular Diseases
Pharmaceutical Preparations
Population

Keywords

  • Antipsychotic
  • Blood pressure
  • Cholesterol
  • Coronary heart disease risk
  • Schizophrenia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry

Cite this

Daumit, G. L., Goff, D. C., Meyer, J. M., Davis, V. G., Nasrallah, H. A., McEvoy, J. P., ... Lieberman, J. A. (2008). Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study. Schizophrenia Research, 105(1-3), 175-187. https://doi.org/10.1016/j.schres.2008.07.006

Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study. / Daumit, Gail L.; Goff, Donald C.; Meyer, Jonathan M.; Davis, Vicki G.; Nasrallah, Henry A.; McEvoy, Joseph Patrick; Rosenheck, Robert; Davis, Sonia M.; Hsiao, John K.; Stroup, T. Scott; Lieberman, Jeffrey A.

In: Schizophrenia Research, Vol. 105, No. 1-3, 01.10.2008, p. 175-187.

Research output: Contribution to journalArticle

Daumit, GL, Goff, DC, Meyer, JM, Davis, VG, Nasrallah, HA, McEvoy, JP, Rosenheck, R, Davis, SM, Hsiao, JK, Stroup, TS & Lieberman, JA 2008, 'Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study', Schizophrenia Research, vol. 105, no. 1-3, pp. 175-187. https://doi.org/10.1016/j.schres.2008.07.006
Daumit, Gail L. ; Goff, Donald C. ; Meyer, Jonathan M. ; Davis, Vicki G. ; Nasrallah, Henry A. ; McEvoy, Joseph Patrick ; Rosenheck, Robert ; Davis, Sonia M. ; Hsiao, John K. ; Stroup, T. Scott ; Lieberman, Jeffrey A. / Antipsychotic effects on estimated 10-year coronary heart disease risk in the CATIE schizophrenia study. In: Schizophrenia Research. 2008 ; Vol. 105, No. 1-3. pp. 175-187.
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abstract = "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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AU - McEvoy, Joseph Patrick

AU - Rosenheck, Robert

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AU - Stroup, T. Scott

AU - Lieberman, Jeffrey A.

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