Is adenosine associated with sudden death in schizophrenia? A new framework linking the adenosine pathway to risk of sudden death

Cardiovascular comorbidities in Chinese inpatients with schizophrenia spectrum disorders

Cardiovascular diseases (CVDs) are the leading cause of premature mortality in patients with schizophrenia spectrum disorders (SSDs). However, the detailed categorization of these conditions remains insufficiently explored. This study aims to identify CVDs comorbidity patterns among inpatients with SSDs and to investigate associated factors. Electronic medical records (EMRs) data from three neuropsychiatric hospitals (2015-2023) in China was conducted. Comorbidity patterns were revealed through latent class analysis (LCA), and multinomial logit analysis were utilized to evaluate the effect of factors on these patterns, calculating odds ratios (ORs) and 95% confidence intervals (CIs). Among the 2830 inpatients with SSD, four distinct comorbidity patterns were identified based on their dominant characteristics: low-risk CVDs (47.86%), primary hypertension (30.15%), heart failure (12.99%), and cardiac valve and vascular disorders (8.99%). Compared to the low-risk CVD group, male patients demonstrated a higher probability of primary hypertension (OR = 1.15) and heart failure (OR = 5.36). Significant associations were observed between comorbid CVDs and the use of typical antipsychotics, atypical antipsychotics, anxiolytics and sedatives, antidepressants, and mood stabilizers. Notably, perphenazine (OR = 22.06) and chlorpromazine hydrochloride (OR = 7.09) were strongly linked to comorbid heart failure. Among Chinese patients with SSDs, four distinct CVD comorbidity patterns were identified, with hypertension and heart failure displaying strong specificity. Variations in demographic characteristics and psychotropic medication use provide valuable insights for treatment and management.

Sudden cardiac arrest in patients with schizophrenia: A population-based study of resuscitation outcomes and pre-existing cardiovascular disease

Objective

Individuals with schizophrenia carry a high burden of cardiovascular disease and elevated rates of sudden cardiac arrest (SCA), but little published data is available regarding survival from SCA in this population. The authors compared cardiovascular disease burden and resuscitation outcomes following SCA in individuals with and without schizophrenia.

Methods

Case-control analysis drawn from a prospective community-based study of SCA in a large community. The authors defined cases as having a pre-SCA history of schizophrenia, and controls as individuals with SCA without a history of schizophrenia. SCA cases with schizophrenia were compared to a 1:5 age- and sex-frequency-matched sample of SCA cases without schizophrenia.

Results

The 103 SCA schizophrenia cases were as likely as the 515 cases without schizophrenia to have resuscitation attempted (75% vs. 80%; p = 0.24) and had a shorter 911 call mean response time (5.8 min vs. 6.9 min, p < 0.001). However, they were significantly less likely to present with a shockable rhythm (ventricular fibrillation/pulseless ventricular tachycardia 16% vs. 43%, p < 0.001), and less likely to survive to hospital discharge (3% vs. 14%, p = 0.008). Pre-arrest cardiovascular disease burden was similar in patients with and without schizophrenia.

Conclusions

Despite comparable resuscitation characteristics and cardiovascular disease burden, patients with schizophrenia had significantly lower rates of SCA survival. The paucity of previous research into this phenomenon warrants further investigation to identify factors that may improve survival.