Evidence map›Paper›PMID 25005706›Full record

Observational studyEuropean heart journal2015

Antipsychotic drugs and risks of myocardial infarction: a self-controlled case series study.

Ruth Brauer, Liam Smeeth, Karim Anaya-Izquierdo, Adam Timmis, Spiros C Denaxas, C Paddy Farrington, Heather Whitaker, Harry Hemingway, Ian Douglas

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in European heart journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 41 citations in OpenAlex.

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  14. Medication safety research by observational study design.International journal of clinical pharmacy · 2016
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Ruth BrauerDepartment of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK ruth.brauer@lshtm.ac.uk.
Liam SmeethDepartment of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Karim Anaya-IzquierdoDepartment of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Adam TimmisNational Institute for Health Research Biomedical Research Unit, Barts Health, London, UK.
Spiros C DenaxasDepartment of Epidemiology and Public Health, Clinical Epidemiology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
C Paddy FarringtonDepartment of Statistics, The Open University, Milton Keynes MK7 6BJ, UK.
Heather WhitakerDepartment of Statistics, The Open University, Milton Keynes MK7 6BJ, UK.
Harry HemingwayDepartment of Epidemiology and Public Health, Clinical Epidemiology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
Ian DouglasDepartment of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
London School of Hygiene & Tropical Medicine · GBThe Open University · GBUniversity College London · GBNational Institute for Health Research · GB

Funding

Cancer Research UKMedical Research Council G0802403Medical Research Council MR/K006584/1Medical Research Council MR/L009005/1Wellcome Trust 086091/Z/08/ZWellcome Trust 098504
6 · The paper itself

Abstract

aimAntipsychotics increase the risk of stroke. Their effect on myocardial infarction remains uncertain because people prescribed and not prescribed antipsychotic drugs differ in their underlying vascular risk making between-person comparisons difficult to interpret. The aim of our study was to investigate this association using the self-controlled case series design that eliminates between-person confounding effects. METHODS AND

resultsAll the patients with a first recorded myocardial infarction and prescription for an antipsychotic identified in the Clinical Practice Research Datalink linked to the Myocardial Ischaemia National Audit Project were selected for the self-controlled case series. The incidence ratio of myocardial infarction during risk periods following the initiation of antipsychotic use relative to unexposed periods was estimated within individuals. A classical case-control study was undertaken for comparative purposes comparing antipsychotic exposure among cases and matched controls. We identified 1546 exposed cases for the self-controlled case series and found evidence of an association during the first 30 days after the first prescription of an antipsychotic, for first-generation agents [incidence rate ratio (IRR) 2.82, 95% confidence interval (CI) 2.0-3.99] and second-generation agents (IRR: 2.5, 95% CI: 1.18-5.32). Similar results were found for the case-control study for new users of first- (OR: 3.19, 95% CI: 1.9-5.37) and second-generation agents (OR: 2.55, 95% CI: 0.93-7.01) within 30 days of their myocardial infarction.

conclusionWe found an increased risk of myocardial infarction in the period following the initiation of antipsychotics that was not attributable to differences between people prescribed and not prescribed antipsychotics.

Indexed as

AdultAgedAged, 80 and overAntipsychotic AgentsCase-Control StudiesFemaleHumansMaleMental DisordersMiddle AgedMyocardial InfarctionRisk FactorsAntipsychotic AgentsAntipsychotic agentsCase–control studyMyocardial infarctionSelf-controlled case series

Identifiers

PMID25005706
PMCPMC4404491
OpenAlexW2109184626

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.