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Mentally Ill Get Fewer Coronary Revascularizations

Last Updated: June 10, 2011.

Following cardiac events, patients with mental illness receive fewer invasive coronary procedures and have higher mortality rates than those without mental illness, according to a meta-analysis published in the June issue of the British Journal of Psychiatry.

FRIDAY, June 10 (HealthDay News) -- Following cardiac events, patients with mental illness receive fewer invasive coronary procedures and have higher mortality rates than those without mental illness, according to a meta-analysis published in the June issue of the British Journal of Psychiatry.

Alex J. Mitchell, M.B.B.S., from the Leicester Royal Infirmary in the United Kingdom, and David Lawrence, Ph.D., from the University of Western Australia in Perth, reviewed the available literature to assess the inequalities in provision of invasive coronary procedures and subsequent mortality in patients with mental illness and schizophrenia, compared to those without. A total of 22 analyses with 825,754 participants were included, of which 10 also examined schizophrenia or related psychosis and six examined mortality.

The investigators found that patients with mental disorders and schizophrenia received fewer coronary procedures than those without (relative risk [RR], 0.86 and 0.53, respectively). Patients with mental disorders had lower receipt of coronary artery bypass grafting (CABG) (RR, 0.85; 95 percent confidence interval [CI], 0.72 to 1.00), cardiac catheterization (RR, 0.85; 95 percent CI, 0.76 to 0.95), and percutaneous transluminal coronary angioplasty (PTCA) or percutaneous coronary intervention (PCI) (RR, 0.87; 95 percent CI, 0.72 to 1.05). Patients with schizophrenia had significantly lower receipt of CABG (RR, 0.69) and PTCA/PCI (RR, 0.50). Mortality up to one year was higher in patients with mental illness (RR, 1.11; P = 0.05), but that of schizophrenia alone could not be examined due to insufficient evidence.

"Following cardiac events, individuals with mental illness appear to receive about 14 percent less frequent therapeutic cardiac procedures (47 percent in the case of schizophrenia), and they have about an 11 percent increased mortality rate," the authors write.

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