Rapid Review: Ascertaining the Type of Potentially Life-Threatening Cardiovascular Events and Eventual Cardiovascular Mortality From Antipsychotic Use in Clinical Practice
Bibliographic record
Abstract
Aims According to the World Health Organization (WHO), there has been a 13% increase in mental health and substance abuse disorders within the last decade. Typical and atypical antipsychotics are the most common treatment mechanisms for mental health-related disorders such as schizophrenia, depression with psychotic symptoms and bipolar disorders. However, antipsychotic usage is associated with more than a 50% increase in CVD such as ischaemic heart disease, resulting in cardiovascular-related mortality. This review aims to investigate the most common type of cardiovascular event causing mortality due to antipsychotic use. Methods A systematic search within PubMed and Medline was conducted on 3 October 2023. Selection criteria were limited to English, full-text studies excluding case reports. The time frame selected was up to 3 October 2023. All studies included adults only. Interventions of focus include typical and atypical antipsychotics licensed in the UK. Outcome measures include cardiovascular mortality/events post-antipsychotic prescription. Results 13 studies were included out of 1088 records. Studies originated from 4 nations with the most studies coming from the USA (n = 7), UK (n = 2), Taiwan (n = 2) and Canada (n = 2). The most common antipsychotic reported in the records was risperidone (n = 11), followed by haloperidol (n = 9), olanzapine (n = 8) and quetiapine (n = 8). From data extraction, the most common cardiovascular events leading to death were sudden cardiac death/arrest (n = 6), ventricular arrhythmias (n = 6), myocardial infarction (n = 4), and heart failure (n = 2). Due to data heterogeneity, discrete outcome measures were extracted from each record. This included outcomes measuring: relative risk between various groups (n = 9), rate of cardiovascular event per 100 patient year (n = 3), and mortality post cardiovascular event (n = 1). Conclusion From this study, ventricular arrhythmias and sudden cardiac deaths were the most common cardiovascular events secondary to antipsychotic use leading to mortality. Owing to patient safety and benefits, patients with psychotic illness are unable to go untreated. They are consequently very vulnerable to the cardiovascular side effects of prescribed high-dose antipsychotic drugs. Despite current monitoring guidelines worldwide, cardiovascular-associated mortality in patients on antipsychotics is still elevated. This may indicate the potential inadequacy of current measures for these patients while demonstrating the need for more aggressive cardioprotective interventions and monitoring.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".