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Risk of myocardial infarction and stroke in bipolar disorder: a systematic review and exploratory meta-analysis.
MedLine Citation:
PMID:  24850482     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To review the evidence on and estimate the risk of myocardial infarction and stroke in bipolar disorder.
METHOD: A systematic search using MEDLINE, EMBASE, PsycINFO, Web of Science, Scopus, Cochrane Database of Systematic Reviews, and bibliographies (1946 - May, 2013) was conducted. Case-control and cohort studies of bipolar disorder patients age 15 or older with myocardial infarction or stroke as outcomes were included. Two independent reviewers extracted data and assessed quality. Estimates of effect were summarized using random-effects meta-analysis.
RESULTS: Five cohort studies including 13 115 911 participants (27 092 bipolar) were included. Due to the use of registers, different statistical methods, and inconsistent adjustment for confounders, there was significant methodological heterogeneity among studies. The exploratory meta-analysis yielded no evidence for a significant increase in the risk of myocardial infarction: [relative risk (RR): 1.09, 95% CI 0.96-1.24, P = 0.20; I(2)  = 6%]. While there was evidence of significant study heterogeneity, the risk of stroke in bipolar disorder was significantly increased (RR 1.74, 95% CI 1.29-2.35; P = 0.0003; I(2)  = 83%).
CONCLUSION: There may be a differential risk of myocardial infarction and stroke in patients with bipolar disorder. Confidence in these pooled estimates was limited by the small number of studies, significant heterogeneity and dissimilar methodological features.
Authors:
M L Prieto; A B Cuéllar-Barboza; W V Bobo; V L Roger; F Bellivier; M Leboyer; C P West; M A Frye
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-5-22
Journal Detail:
Title:  Acta psychiatrica Scandinavica     Volume:  -     ISSN:  1600-0447     ISO Abbreviation:  Acta Psychiatr Scand     Publication Date:  2014 May 
Date Detail:
Created Date:  2014-5-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370364     Medline TA:  Acta Psychiatr Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
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