Prevalence of cardiovascular and metabolic events in patients prescribed clozapine: a retrospective observational, clinical cohort study

Hyde, Natalie, Dodd, Seetal, Venugopal, Kamalesh, Purdie, Christa, Berk, Michael and O'Neil, Adrienne 2015, Prevalence of cardiovascular and metabolic events in patients prescribed clozapine: a retrospective observational, clinical cohort study, Current Drug Safety, vol. 10, no. 2, pp. 125-131.

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Title Prevalence of cardiovascular and metabolic events in patients prescribed clozapine: a retrospective observational, clinical cohort study
Author(s) Hyde, Natalie
Dodd, SeetalORCID iD for Dodd, Seetal orcid.org/0000-0002-7918-4636
Venugopal, Kamalesh
Purdie, Christa
Berk, MichaelORCID iD for Berk, Michael orcid.org/0000-0002-5554-6946
O'Neil, Adrienne
Journal name Current Drug Safety
Volume number 10
Issue number 2
Start page 125
End page 131
Total pages 7
Publisher Bentham Science Publishers
Place of publication San Francisco, Calif.
Publication date 2015
ISSN 1574-8863
2212-3911
Keyword(s) Adverse event
cardiac
cardiomyopathy
clozapine
metabolic
myocarditis
prevalence
schizophrenia
Summary BACKGROUND: The efficacy of clozapine for the treatment of schizophrenia has been demonstrated. However, a range of adverse events have been associated with its use. To date, there remains a paucity of data regarding the prevalence of clozapine-induced cardiovascular (CV) and parameters associated with the development of metabolic syndrome, alongside associated risk factors for their development. METHODS: An observational, clinical cohort study design of 355 clozapine patients who were enrolled in the Barwon Health Clozapine Program at Geelong Hospital, Victoria, Australia, between 2008-12. Medical records were accessed retrospectively. Multivariate logistic regression was used to determine associations with adverse event(s). RESULTS: Older age of commencement with clozapine was consistently associated with increased risk of CV abnormalities, with the exception of tachycardia where older age was protective (Odds Ratio [OR]: 0.97; 95% Confidence Intervals [CI]: 0.95, 0.99). Males had significantly greater odds of most metabolic disturbances with the exception of being obese (BMI: ≥30 OR: 0.45; 95% CIs: 0.24, 0.85). Older age of commencement was a significantly associated variable with High- Density Lipoprotein-cholesterol (OR: 1.03; 95% CIs: 1.01, 1.07) and fasting glucose (OR:1.04; 95% CIs: 1.02, 1.07). An increase in BMI was consistently and significantly associated with all metabolic events. CONCLUSION: Male patients who are obese at any point during treatment and older at treatment commencement may be the most vulnerable to adverse CV and metabolic events. While future studies using a matched case-control design may be required to verify these findings, we recommend that treating clinicians consider these risks when assessing patient suitability to clozapine therapy.
Language eng
Field of Research 110319 Psychiatry (incl Psychotherapy)
Socio Economic Objective 920410 Mental Health
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Bentham Science Publishers
Persistent URL http://hdl.handle.net/10536/DRO/DU:30073853

Document type: Journal Article
Collection: School of Medicine
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