ArticleBMC medicine2021
Severe mental illness and mortality and coronary revascularisation following a myocardial infarction: a retrospective cohort study.
Article in BMC medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Respiratory disease in people with bipolar disorder: a systematic review and meta-analysis.Molecular psychiatry · 2025Pooled it
- Mortality, Revascularization, and Cardioprotective Pharmacotherapy After Acute Coronary Syndrome in Patients With Severe Mental Illness: A Systematic Review and Meta-analysis.Schizophrenia bulletin · 2022Pooled it
- Pooled it
- Mental disorders, receipt of cardiac care following myocardial infarction and the impact of the COVID-19 pandemic: a cohort study.BMJ open · 2026Article
- Impact of schizophrenia on coronary artery bypass grafting outcomes: a nationwide analysis.Annals of medicine and surgery (2012) · 2026Article
- Mental disorders, mortality following myocardial infarction, and the impact of the COVID-19 pandemic in England: a cohort study.European heart journal. Quality of care & clinical outcomes · 2026Article
- Guideline-directed Low-density Lipoprotein Cholesterol Management After Acute Coronary Syndrome in Patients With Mental Illness: a Population-based Study.Cardiovascular drugs and therapy · 2026Article
- Inequalities in Access to and Outcomes of Cardiac Surgery Among Patients with Mental Health Disorders.Medical sciences (Basel, Switzerland) · 2026Review
- A nationwide Scottish cohort study of the association between pre-existing mental illness and out-of-hospital cardiac arrest survival.Resuscitation plus · 2026Article
- Depression, Anxiety, and Bipolar Disorder and Atherosclerosis.Current atherosclerosis reports · 2026Review
- Assessing Care of Patients with Severe Mental Illness in the Era of Primary Angioplasty Pathways for ST-elevation MI Using Artificial Intelligence Methods.Interventional cardiology (London, England) · 2026Article
- The Bidirectional Relationship Between Myocardial Infarction and Depression: Risk Factors, Mechanisms, and Interventions.Biomedicines · 2025Review
- Poor Mental Health Status as a Risk Factor and Prognosticator in SMuRF-Less Acute Myocardial Infarction.Journal of clinical medicine · 2025Article
- The association of depression and patient and resuscitation characteristics with survival after out-of-hospital cardiac arrest: a cohort study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Severe mental illness and cardioprotective medication prescribing: a qualitative study in general practice.BJGP open · 2024Article
- Severe depression and all-cause and cause-specific mortality in Scotland: 20 year national cohort study.BJPsych open · 2024Article
- Exploring the Association between Schizophrenia and Cardiovascular Diseases: Insights into the Role of Sigma 1 Receptor.Physiological research · 2023Review
- A Narrative Review of the Association Between Depression and Heart Disease Among Women: Prevalence, Mechanisms of Action, and Treatment.Current atherosclerosis reports · 2022Review
- Mental health conditions and risk of first-ever ischaemic stroke and death in patients with incident atrial fibrillation: A nationwide cohort study.European journal of clinical investigation · 2022Article
- Mental health conditions and use of rhythm control therapies in patients with atrial fibrillation: a nationwide cohort study.BMJ open · 2022Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundSevere mental illness (SMI), comprising schizophrenia, bipolar disorder and major depression, is associated with higher myocardial infarction (MI) mortality but lower coronary revascularisation rates. Previous studies have largely focused on schizophrenia, with limited information on bipolar disorder and major depression, long-term mortality or the effects of either sociodemographic factors or year of MI. We investigated the associations between SMI and MI prognosis and how these differed by age at MI, sex and year of MI.
methodsWe conducted a national retrospective cohort study, including adults with a hospitalised MI in Scotland between 1991 and 2014. We ascertained previous history of schizophrenia, bipolar disorder and major depression from psychiatric and general hospital admission records. We used logistic regression to obtain odds ratios adjusted for sociodemographic factors for 30-day, 1-year and 5-year mortality, comparing people with each SMI to a comparison group without a prior hospital record for any mental health condition. We used Cox regression to analyse coronary revascularisation within 30 days, risk of further MI and further vascular events (MI or stroke). We investigated associations for interaction with age at MI, sex and year of MI.
resultsAmong 235,310 people with MI, 923 (0.4%) had schizophrenia, 642 (0.3%) had bipolar disorder and 6239 (2.7%) had major depression. SMI was associated with higher 30-day, 1-year and 5-year mortality and risk of further MI and stroke. Thirty-day mortality was higher for schizophrenia (OR 1.95, 95% CI 1.64-2.30), bipolar disorder (OR 1.53, 95% CI 1.26-1.86) and major depression (OR 1.31, 95% CI 1.23-1.40). Odds ratios for 1-year and 5-year mortality were larger for all three conditions. Revascularisation rates were lower in schizophrenia (HR 0.57, 95% CI 0.48-0.67), bipolar disorder (HR 0.69, 95% CI 0.56-0.85) and major depression (HR 0.78, 95% CI 0.73-0.83). Mortality and revascularisation disparities persisted from 1991 to 2014, with absolute mortality disparities more apparent for MIs that occurred around 70 years of age, the overall mean age of MI. Women with major depression had a greater reduction in revascularisation than men with major depression.
conclusionsThere are sustained SMI disparities in MI intervention and prognosis. There is an urgent need to understand and tackle the reasons for these disparities.
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