Table 3.
Relative risks of all-cause mortality (excluding suicide) and cardiovascular outcomes for current users of various types of antipsychotics versus nonuser psychiatric controls.
| Outcome |
Exposure type | Number of events | PY | Incidence rate per 1000 PY (95% CI) |
Age-and sex-adjusted relative risk (RR) (95% CI) | Fully adjusted RR (aRR) (95% CI) |
|---|---|---|---|---|---|---|
| All-cause mortality | Nonuser psychiatric | 7765 | 307,276 | 25.3 (24.7–25.8) | Reference | Reference |
| Atypical or typical | 23,841 | 276,892 | 86.1 (85.0–87.2) | 2.15 (2.10–2.21)‡ | 1.75 (1.64–1.87)‡ | |
| Atypical | 7356 | 94,112 | 78.2 (76.4–80.0) | 1.76 (1.71–1.82)‡ | 1.52 (1.40–1.64)‡ | |
| Typical | 15473 | 167,005 | 92.7 (91.2–94.1) | 2.34 (2.28–2.41)‡ | 1.82 (1.69–1.98)‡ | |
| Olanzapine | 1305 | 34,985 | 37.3 (35.3–39.4) | 1.40 (1.32–1.48)‡ | 1.04 (0.93–1.17) | |
|
| ||||||
| Cardiac mortality | Nonuser psychiatric | 1289 | 200,988 | 6.4 (6.1–6.8) | Reference | Reference |
| Atypical or typical | 2478 | 145,643 | 17.0 (16.4–17.7) | 1.62 (1.52–1.74)‡ | 1.72 (1.42–2.07)‡ | |
| Atypical | 1200 | 73,284 | 16.4 (15.5–17.3) | 1.47 (1.36–1.59)‡ | 1.74 (1.40–2.14)‡ | |
| Typical | 1180 | 64,913 | 18.2 (17.2–19.3) | 1.78 (1.64–1.92)‡ | 1.88 (1.49–2.39)‡ | |
| Olanzapine | 206 | 26,765 | 7.7 (6.7–8.8) | 1.25 (1.07–1.44)‡ | 1.53 (1.12–2.09)‡ | |
|
| ||||||
| SCD—primary definition | Nonuser psychiatric | 10 | 23,872 | 0.4 (0.2–0.8) | Reference | Reference |
| Atypical or typical | 44 | 16,144 | 2.7 (2.0–3.7) | 5.76 (2.90–11.45)‡ | 5.76 (2.90–11.45)‡ | |
| Atypical | 21 | 10,201 | 2.1 (1.3–3.2) | 0 (NC) | 0 (NC) | |
| Typical | 21 | 5415 | 3.9 (2.4–5.9) | 0 (NC) | 0 (NC) | |
| Olanzapine | 6 | 3454 | 1.7 (0.6–3.8) | 0 (NC) | 0 (NC) | |
|
| ||||||
| SCD—secondary definition | Nonuser psychiatric | 98 | 23,873 | 4.1 (3.3–5.0) | Reference | Reference |
| Atypical or typical | 178 | 16,144 | 11.0 (9.5–12.8) | 2.36 (1.84–3.02)‡ | 2.15 (1.64–2.81)‡ | |
| Atypical | 90 | 10,201 | 8.8 (7.1–10.8) | 1.93 (1.45–2.57)‡ | 1.79 (1.33–2.42)‡ | |
| Typical | 78 | 5415 | 14.4 (11.4–18.0) | 2.82 (2.09–3.80)‡ | 3.99 (1.29–12.40)† | |
| Olanzapine | 10 | 3454 | 2.9 (1.4–5.3) | 1.33 (0.69– 2.57) | 0 (NC) | |
|
| ||||||
| SCD—tertiary definition | Nonuser psychiatric | 119 | 64,880 | 1.8 (1.5–2.2) | Reference | Reference |
| Atypical or typical | 198 | 43,550 | 4.6 (3.9–5.2) | 1.92 (1.53–2.42)‡ | 1.79 (1.42–2.27)‡ | |
| Atypical | 97 | 26,345 | 3.7 (3.0–4.5) | 1.60 (1.22–2.09)‡ | 1.51 (1.14–1.99)‡ | |
| Typical | 96 | 15,621 | 6.2 (5.0–7.5) | 2.39 (1.82–3.13)‡ | 2.27 (1.71–3.01)‡ | |
| Olanzapine | 15 | 8425 | 1.8 (1.0–2.9) | 1.61 (0.93–2.77)* | 0 (NC) | |
|
| ||||||
| CHD | Nonuser psychiatric | 982 | 278,330 | 3.5 (3.3–3.8) | Reference | Reference |
| Atypical or typical | 1355 | 236,229 | 5.7 (5.4–6.1) | 1.08 (1.00–1.18)* | 1.16 (0.94–1.44) | |
| Atypical | 444 | 86,115 | 5.2 (4.7–5.7) | 0.94 (0.84–1.05) | 0.98 (0.76–1.26) | |
| Typical | 873 | 136,777 | 6.4 (6.0–6.8) | 1.19 (1.09–1.31)‡ | 1.39 (1.09–1.76)‡ | |
| Olanzapine | 132 | 31,806 | 4.2 (3.5–4.9) | 1.01 (0.84–1.21) | 1.07 (0.76–1.49) | |
|
| ||||||
| Ventricular arrhythmias | Nonuser psychiatric | 500 | 279,243 | 1.8 (1.6–2.0) | Reference | Reference |
| Atypical or typical | 646 | 237,647 | 2.7 (2.5–2.9) | 1.14 (1.01–1.28)† | 1.16 (1.02–1.31)† | |
| Atypical | 230 | 86,319 | 2.7 (2.3–3.0) | 1.05 (0.89–1.23) | 1.06 (0.90–1.26) | |
| Typical | 382 | 137,982 | 2.8 (2.5–3.1) | 1.16 (1.01–1.32)† | 1.37 (1.00–1.87)* | |
| Olanzapine | 55 | 31,921 | 1.7 (1.3–2.2) | 0.90 (0.68–1.18) | 0.86 (0.65–1.14) | |
*P < 0.10, † P < 0.05, ‡ P < 0.01.
Abbreviations: aRR: adjusted relative risk; CHD: coronary heart disease; CI: confidence interval; NC: not calculated; PY: person-years; SCD: sudden cardiac death.