Coronary artery disease and schizophrenia: the interplay of heart and mind

The Outcomes of Acute Coronary Syndrome in Patients Suffering From Schizophrenia: A Systematic Review

“…Socioeconomic factors, such as poverty and lower educational attainment, are more prevalent in patients with schizophrenia compared to those without [17]. When these factors are combined with behavioral risk factors seen in patients with schizophrenia, such as substance abuse, tobacco smoking, sedentary lifestyle, and obesity, they may culminate in increased susceptibility to developing cardiac risk factors (like diabetes and metabolic syndrome) and not pursuing positive health choices [8,10].…”

“…Healthcare factors: It is possible that patients suffering from schizophrenia receive suboptimal care at multiple levels in the healthcare system, which may lead to the persistently higher-than-expected mortality from ACS when compared to the general population [23,26]. Starting with primary prophylactic management, cardiovascular risk factors, documentation, and management are reported to be suboptimal in patients with schizophrenia [17]. Moreover, rates of revascularization post-ACS in patients with schizophrenia are almost half as much as those seen in the general population [17].…”

“…Starting with primary prophylactic management, cardiovascular risk factors, documentation, and management are reported to be suboptimal in patients with schizophrenia [17]. Moreover, rates of revascularization post-ACS in patients with schizophrenia are almost half as much as those seen in the general population [17]. In addition, during the post-myocardial infarction (MI) care, there are further dissimilarities in providing care, with lower rates of cardiology specialist visits in the 30-days post-ACS in patients with schizophrenia when compared to those without (12.2% vs 20.1%, respectively) [30].…”

“…Moreover, it has been shown that there is inequality in the management of ACS between patients with schizophrenia and mentally healthy patients with lower rates of revascularization and cardioprotective therapy prescriptions [12][13][14][15][16]. As a consequence, a number of recent studies have explored whether ACS outcomes are worse in patients with schizophrenia using various study designs [17].…”