Pulmonary embolism major cause of cardiac arrest in those with psychiatric disorders
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Results of a 5-year study in Japan suggest pulmonary embolism may be a major cause of sudden cardiac arrest among patients with psychiatric disorders.
Researchers published these results in Journal of Clinical Psychiatry.
“Many psychiatrists consider that ischemic heart disease is the chief cause of premature death among psychiatric patients,” co-author Takuto Ishida, MD, PhD, of the Tertiary Emergency Medical Center at Tokyo Metropolitan Bokutoh Hospital, told Healio Psychiatry. “On the other hand, many emergency physicians consider that pulmonary embolism (PE), not ischemic heart disease, is far more common among psychiatric patients than the general population. To address this knowledge gap between psychiatrists and emergency physicians, we conducted this study.”
Previous studies have shown that psychiatric patients have higher risk for both acute myocardial infarction (AMI) and PE, but because incidence of PE is lower than that of AMI in the general population, PE receives relatively little attention from psychiatrists, Ishida and colleagues wrote.
Ishida and colleagues hypothesized that disease burden of PE among psychiatric patients may be comparable to that of AMI. They collected data from Japan’s Ministry of Health, Labor and Welfare from more than 400,000 patients who had been hospitalized between April 2013 and March 2018 with symptoms of heart disease. Of those, 351,159 had symptoms of AMI and 52,036 had symptoms of PE. Mean age of those experiencing AMI was 70.3 years and PE was 69.2 years.
Results showed death rates between 8% and 14.4% in patients with AMI and between 4.3% and 9.8% in patients with PE and concurrent psychiatric issues. In addition, proportions of patients diagnosed with schizophrenia and mood disorders were found to be noticeably higher in the PE group (2.53% and 0.55%, respectively) than in the AMI group (2.94% and 0.6%, respectively).
“It is well known that the life expectancy of psychiatric patients is 10 to 20 years shorter than the general population,” Ishida said. “Many psychiatrists consider that ischemic heart disease is the chief cause.
“Consequently, interventions have focused on prevention of ischemic heart disease and treatment of metabolic syndrome,” Ishida added. “These interventions are certainly very important. However, incidence of PE among psychiatric patients is extremely high and comparable to AMI. Hence, interventions on prevention for PE [are just as] important.”