Background Coronary heart disease (CHD) is a major cause of increased mortality rates in patients with schizophrenia. Moreover, coronary artery calcium (CAC) score is associated with CHD. We hypothesized that patients with schizophrenia have more CAC than the general population and aimed to investigate the CAC score in patients with schizophrenia compared to norms based on the general population. Additionally, this study investigated if age, sex, diabetes, dyslipidemia and smoking were associated with the CAC score. Methods In a cross-sectional study, 163 patients with schizophrenia underwent cardiac computed tomography, and the CAC score was measured and compared to norms by classifying the CAC scores in relation to the age- and gender matched norm 50th, 75th and 90th percentiles. Logistic and linear regression were carried out to investigate explanatory variables for the presence and extent of CAC, respectively. Results A total of 127 (77.9%) patients had a CAC score below or equal to the matched 50th, 20 (12.3%) above the 75th and nine (5.5%) above the 90th percentile. Male sex (P < 0.05), age (P < 0.001) and smoking (P < 0.05) were associated with the presence of CAC while age (P < 0.001) and diabetes (P < 0.01) were associated with the extent of CAC. Conclusions The amount of CAC in patients with schizophrenia follows norm percentiles, and variables associated with the CAC score are similar in patients with schizophrenia and the general population. These findings indicate that the CAC score may not be sufficient to detect the risk of CHD in patients with schizophrenia. Future studies should explore other measures of subclinical CHD, including measures of peripheral atherosclerosis or cardiac autonomic neuropathy to improve early detection and intervention. Trial registration ClinicalTrials.gov Identifier: NCT02885792, September 1, 2016.

Background Coronary artery disease (CAD) is one of the major causes of premature mortality in patients with schizophrenia. Coronary artery calcification (CAC) is an independent predictor of cardiac mortality and CAD in the general population, but has not yet been investigated in patients with schizophrenia. The aim of the present study is to compare CAC quantified by cardiac computed tomography (CT) in patients with schizophrenia to the general population. Methods Baseline data from an ongoing prospective cohort study including 200 patients with schizophrenia (ICD-10 diagnoses F20 or F25) diagnosed at least 10 years prior to inclusion (chronic group) and 86 patients with schizophrenia diagnosed within two years prior to inclusion (debut group). Patients in the debut group were matched 1:1 on age, gender and smoking status with psychiatrically healthy controls (PHC). All participants underwent cardiac CT and the CAC was quantified using Agatston Score. Mean CAC in the chronic group was compared to reference CAC scores whilst mean CAC in the debut group was compared to PHC. Information on cardiovascular risk factors, illness history, social and psychiatric conditions were obtained at baseline. Results Data is currently being analyzed and results will be presented at the Congress of International Schizophrenia Research Society. Discussion If the CAC quantified by CT in patients with schizophrenia differs from the PHC population, it might act as a tool for early detection of CAD in these patients. Thus, the findings of this study might contribute to preventive strategies in order to decrease cardiovascular mortality.

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