Table 5.
Relative risks of all-cause mortality (excluding suicide) and cardiovascular outcomes for current users of various types of antipsychotics versus nonuser psychiatric controls stratified by dose.
| Outcome | Exposure type of current users | Dose | Outcome events | Person-time (Years) | Incidence rate per 1000 PY (95% CI) |
Fully adjusted RR (aRR) (95% CI) |
|---|---|---|---|---|---|---|
| All-cause mortality | Nonuser psychiatric | NA | 7765 | 307,276 | 25.3 (24.7–25.8) | Reference |
| Atypical or typical | Low | 21,208 | 218,635 | 97.0 (95.7–98.3) | 1.72 (1.62–1.84)‡ | |
| Medium | 1978 | 37,704 | 52.5 (50.2–54.8) | 1.94 (1.80–2.10)‡ | ||
| High | 655 | 20,553 | 31.9 (29.5–34.4) | 1.89 (1.71–2.09)‡ | ||
| Atypical | Low | 5969 | 51,838 | 115.2 (112.3–118.1) | 1.51 (1.40–1.64)‡ | |
| Medium | 1106 | 28,874 | 38.3 (36.1–40.6) | 1.54 (1.40–1.69)‡ | ||
| High | 281 | 13,401 | 21.0 (18.6–23.6) | 1.48 (1.29–1.71)‡ | ||
| Typical | Low | 14,528 | 160,264 | 90.7 (89.2–92.1) | 1.76 (1.63–1.89)‡ | |
| Medium | 683 | 4232 | 161.4 (149.5–174.0) | 3.74 (3.36–4.15)‡ | ||
| High | 262 | 2509 | 104.4 (92.2–117.9) | 3.61 (3.14–4.16)‡ | ||
| Olanzapine | Low | 873 | 17,172 | 50.8 (47.5–54.3) | 1.00 (0.88–1.13) | |
| Medium | 323 | 12,304 | 26.3 (23.5–29.3) | 1.07 (0.92–1.24) | ||
| High | 109 | 5509 | 19.8 (16.3–23.9) | 1.20 (0.97–1.49)* | ||
|
| ||||||
| Cardiac Mortality | Nonuser psychiatric | NA | 1289 | 200,988 | 6.4 (6.1–6.8) | Reference |
| Atypical or typical | Low | 2157 | 107,874 | 20.0 (19.2–20.9) | 1.65 (1.36–2.00)‡ | |
| Medium | 251 | 25,299 | 9.9 (8.7–11.2) | 2.10 (1.68–2.63)‡ | ||
| High | 70 | 12,470 | 5.6 (4.4–7.1) | 2.27 (1.68–3.07)‡ | ||
| Atypical | Low | 984 | 42,824 | 23.0 (21.6–24.5) | 1.35 (1.24–1.47)‡ | |
| Medium | 173 | 21,258 | 8.1 (7.0–9.5) | 1.67 (1.42–1.97)‡ | ||
| High | 43 | 9202 | 4.7 (3.4–6.3) | 1.84 (1.35–2.51)‡ | ||
| Typical | Low | 1108 | 61,999 | 17.9 (16.8–19.0) | 1.82 (1.44–2.32)‡ | |
| Medium | 57 | 1862 | 30.6 (23.2–39.7) | 3.40 (2.39–4.83)‡ | ||
| High | 15 | 1053 | 14.3 (8.0–23.5) | 3.13 (1.79–5.47)‡ | ||
| Olanzapine | Low | 129 | 13,897 | 9.3 (7.8–11.0) | 1.31 (0.93–1.82) | |
| Medium | 60 | 8851 | 6.8 (5.2–8.7) | 2.06 (1.41–3.01)‡ | ||
| High | 17 | 4016 | 4.2 (2.5–6.8) | 2.37 (1.36–4.12)‡ | ||
|
| ||||||
| SCD (secondary definition) | Nonuser psychiatric | NA | 98 | 23,873 | 4.1 (3.3–5.0) | Reference |
| Atypical or typical | Low | 157 | 11,914 | 13.2 (11.2–15.4) | 2.09 (1.60–2.75)‡ | |
| Medium | 14 | 2956 | 4.7 (2.6–8.0) | 2.42 (1.35–4.35)‡ | ||
| High | 7 | 1274 | 5.5 (2.2–11.3) | 3.36 (1.50–7.50)‡ | ||
| Atypical | Low | 82 | 6469 | 12.7 (10.1-15.7) | 1.78 (1.31–2.42)‡ | |
| Medium | 6 | 2660 | 2.3 (0.8–4.9) | 1.32 (0.57–3.05) | ||
| High | 2 | 1072 | 1.9 (0.2–6.7) | 1.53 (0.37–6.39) | ||
| Typical | Low | 70 | 5202 | 13.5 (10.5–17.0) | 2.48 (1.81–3.40)‡ | |
| Medium | 5 | 156 | 32.1 (10.4–74.8) | 6.07 (2.45–14.99)‡ | ||
| High | 3 | 57 | 52.8 (10.9–154.3) | 10.05 (3.15–32.08)‡ | ||
| Olanzapine | Low | 8 | 1951 | 4.1 (1.8–8.1) | 0 (NC) | |
| Medium | 2 | 1052 | 1.9 (0.2–6.9) | 0 (NC) | ||
| High | 0 | 451 | 0.0 (0.0-8.2) | 0 (NC) | ||
|
| ||||||
| CHD | Nonuser psychiatric | NA | 982 | 278,330 | 3.5 (3.3–3.8) | Reference |
| Atypical or typical | Low | 1192 | 185,032 | 6.4 (6.1–6.8) | 1.19 (0.96–1.48) | |
| Medium | 126 | 33,440 | 3.8 (3.1–4.5) | 1.15 (0.88–1.50) | ||
| High | 37 | 17,757 | 2.1 (1.5 –2.9) | 0.86 (0.59–1.26) | ||
| Atypical | Low | 328 | 48,223 | 6.8 (6.1–7.6) | 0.94 (0.72–1.23) | |
| Medium | 95 | 26,059 | 3.7 (3.0–4.5) | 1.11 (0.81–1.51) | ||
| High | 21 | 11,833 | 1.8 (1.1–2.7) | 0.77 (0.47–1.26) | ||
| Typical | Low | 843 | 131,363 | 6.4 (6.0–6.9) | 1.40 (1.10–1.78)‡ | |
| Medium | 20 | 3413 | 5.9 (3.6–9.1) | 1.25 (0.76–2.05) | ||
| High | 10 | 2001 | 5.0 (2.4–9.2) | 1.54 (0.80–2.98) | ||
| Olanzapine | Low | 76 | 15,856 | 4.8 (3.8–6.0) | 0.99 (0.68–1.45) | |
| Medium | 46 | 11,029 | 4.2 (3.1–5.6) | 1.34 (0.89–2.01) | ||
| High | 10 | 4921 | 2.0 (1.0–3.7) | 0.82 (0.42–1.63) | ||
|
| ||||||
| Ventricular arrhythmias | Nonuser psychiatric | NA | 500 | 279,243 | 1.8 (1.6–2.0) | Reference |
| Atypical or typical | Low | 540 | 186,417 | 2.9 (2.7–3.2) | 1.13 (0.99–1.29)* | |
| Medium | 70 | 33,445 | 2.1 (1.6–2.6) | 1.27 (0.98–1.64)* | ||
| High | 36 | 17,784 | 2.0 (1.4–2.8) | 1.55 (1.08–2.20)† | ||
| Atypical | Low | 163 | 48,398 | 3.4 (2.9–3.9) | 1.03 (0.85–1.24) | |
| Medium | 48 | 26,079 | 1.8 (1.4–2.4) | 1.12 (0.83–1.51) | ||
| High | 19 | 11,842 | 1.6 (1.0–2.5) | 1.27 (0.79–2.02) | ||
| Typical | Low | 359 | 132,550 | 2.7 (2.4–3.0) | 1.13 (0.98–1.31)* | |
| Medium | 16 | 3416 | 4.7 (2.7–7.6) | 2.23 (1.35–3.69)‡ | ||
| High | 7 | 2017 | 3.5 (1.4–7.2) | 2.11 (0.99–4.47)* | ||
| Olanzapine | Low | 33 | 15,926 | 2.1 (1.4–2.9) | 0.84 (0.59–1.20) | |
| Medium | 14 | 11,068 | 1.3 (0.7–2.1) | 0.78 (0.46–1.33) | ||
| High | 8 | 4927 | 1.6 (0.7–3.2) | 1.22 (0.60–2.46) | ||
*P < 0.10, † P < 0.05, ‡ P < 0.01.
Abbreviations: aRR: adjusted relative risk; CHD: coronary heart disease; CI: confidence interval; NC: not calculable; PY: person-years; SCD: sudden cardiac death.