Risk of myocardial infarction and stroke in bipolar disorder: A systematic review and exploratory meta-analysis

M. L. Prieto, A. B. Cuéllar-Barboza, William V Bobo, Veronique Lee Roger, F. Bellivier, M. Leboyer, Colin Patrick West, Mark A Frye

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

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; I2 = 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; I2 = 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.

Original languageEnglish (US)
Pages (from-to)342-353
Number of pages12
JournalActa Psychiatrica Scandinavica
Volume130
Issue number5
DOIs
StatePublished - Nov 1 2014

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Bipolar Disorder
Meta-Analysis
Stroke
Myocardial Infarction
Cohort Studies
Bibliography
MEDLINE
Case-Control Studies
Databases

Keywords

  • Bipolar disorder
  • Cardiovascular diseases
  • Meta-analysis
  • Myocardial infarction
  • Stroke

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Risk of myocardial infarction and stroke in bipolar disorder : A systematic review and exploratory meta-analysis. / Prieto, M. L.; Cuéllar-Barboza, A. B.; Bobo, William V; Roger, Veronique Lee; Bellivier, F.; Leboyer, M.; West, Colin Patrick; Frye, Mark A.

In: Acta Psychiatrica Scandinavica, Vol. 130, No. 5, 01.11.2014, p. 342-353.

Research output: Contribution to journalArticle

Prieto, M. L. ; Cuéllar-Barboza, A. B. ; Bobo, William V ; Roger, Veronique Lee ; Bellivier, F. ; Leboyer, M. ; West, Colin Patrick ; Frye, Mark A. / Risk of myocardial infarction and stroke in bipolar disorder : A systematic review and exploratory meta-analysis. In: Acta Psychiatrica Scandinavica. 2014 ; Vol. 130, No. 5. pp. 342-353.
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