title: Unrecognised myocardial infarction in patients with schizophrenia.
abstract: OBJECTIVE
  Schizophrenia is associated with a reduction of the lifespan by 20 years, with type II diabetes and cardiovascular disease contributing the most to the increased mortality. Unrecognised or silent myocardial infarction (MI) occurs in ~30% of the population, but the rates of unrecognised MI in patients with schizophrenia have only been sparsely investigated.
  
  
  METHODS
  Electrocardiograms (ECG) from three psychiatric hospitals in Denmark were manually interpreted for signs of previous MI. Subsequently, ECGs were linked to the National Patient Registry in order to determine whether patients had a diagnosis consistent with previous MI.
  
  
  RESULTS
  A total of 937 ECGs were interpreted, 538 men (57.4%) and 399 women (42.6%). Mean age at the time of ECG acquisition was 40.6 years (95% CI: 39.7-41.5, range: 15.9-94.6). We identified 32 patients with positive ECG signs of MIs. Only two of these patients had a diagnosis of MI in the National Patient Registry. An additional number of eight patients had a diagnosis of MI in the Danish National Patient Registry, but with no ECG signs of previous MI. This means that 30 out of 40 (75%) MIs were unrecognised. Only increasing age was associated with unrecognised MI in a stepwise multiple logistic regression model compared with patients with no history of MI, OR: 1.03 per year of age, 95% CI: 1.00-1.06, p=0.021.
  
  
  CONCLUSIONS
  Unrecognised MI is common among patients with schizophrenia and may contribute to the increased mortality found in this patient group.
authors.affiliation: 1Department of Psychiatry,Aalborg University Hospital,Aalborg,Denmark.
authors.forename: Jimmi
authors.initials: J
authors.lastname: Nielsen
authors.affiliation: 1Department of Psychiatry,Aalborg University Hospital,Aalborg,Denmark.
authors.forename: Jacob
authors.initials: J
authors.lastname: Juel
authors.forename: Karam Sadoon
authors.initials: KS
authors.lastname: Alzuhairi
authors.affiliation: 1Department of Psychiatry,Aalborg University Hospital,Aalborg,Denmark.
authors.forename: Karam Sadoon Majeed
authors.initials: KS
authors.lastname: Al Zuhairi
authors.affiliation: 1Department of Psychiatry,Aalborg University Hospital,Aalborg,Denmark.
authors.forename: Rasmus
authors.initials: R
authors.lastname: Friis
authors.affiliation: 4Department of Health Science and Technology,Aalborg University,Aalborg,Denmark.
authors.forename: Claus
authors.initials: C
authors.lastname: Graff
authors.affiliation: 5Laboratory of Experimental Cardiology,Department of Biomedical Sciences,Copenhagen University,København,Denmark.
authors.forename: Jørgen Kim
authors.initials: JK
authors.lastname: Kanters
authors.affiliation: 2Department of Clinical Medicine,Aalborg University,Aalborg,Denmark.
authors.forename: Svend Eggert
authors.initials: SE
authors.lastname: Jensen
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D011379:Prognosis; D012042:Registries; D012559:Schizophrenia / Q000453:epidemiology / Q000503:physiopathology*
keywords: psychosis