Background: Studies have shown that a diagnosis of schizophrenia is associated with lower utilization of stents and higher mortality among patients with an acute myocardial infarction. We wished to investigate difference in outcomes and utilization of other procedures in a large population.
Methods: In a retrospective cohort study, using the 2014 Nationwide Inpatient Sample (NIS), we analyzed adult patients with AMI,
who had a diagnosis of schizophrenia. We performed univariate analysis of age, sex, race, hospital location, hospital teaching status, insurance type, hospital bed size, Charlson Comorbidity Index and other relevant comorbidities and we included variables with p<0.2 in the multivariate logistic regression model.
Results: A total of 115,042 patients with AMI were examined. As compared to patients without schizophrenia, patients with a diagnosis of schizophrenia (n=625) were younger (AMI: 61± 0.5, vs 67 ± 0.1, p<0001); and had a higher prevalence of diabetes mellitus (37% vs 31%, p<0.008). Schizophrenia was associated with lower utilization of stents, OR= 0.48, p<0.001. Furthermore, patients with schizophrenia and AMI were less likely to receive stent implantation within 48 hours, OR=0.50, p<0.001. A smaller proportion of patients with schizophrenia were treated with coronary artery bypass grafts, OR=0.61, p=0.0017. The use of fibrinolytic therapy, invasive catheterization, mechanical ventilation, implantable cardioverter-defibrillator, and short-term mechanical circulatory support was similar in patients with schizophrenia as compared with patients without this diagnosis. Patients with schizophrenia and AMI were more likely to be in acute heart failure exacerbation, OR= 1.29, p=0.04. Although the hospital length of stay was longer in patients with schizophrenia, Coef.=0.97, p=0.003, total charges were lower, Coef. = -12241$, p=0.014, presumably due to lower rates of revascularization. Hospital mortality was similar between the two groups.
Conclusion: Patients with schizophrenia appear to be less aggressively treated. Although there is a higher incidence of heart failure exacerbations in patients with AMI and schizophrenia, hospital mortality is similar.

A DIAGNOSIS OF SCHIZOPHRENIA IS ASSOCIATED WITH LOWER UTILIZATION OF STENTS AND CORONARY ARTERY BYPASS GRAFTS AMONG PATIENTS WITH ACUTE MYOCARDIAL INFARCTION: A NATIONWIDE ANALYSIS USING THE NATIONAL INPATIENT SAMPLE DATABASE OF 2014

[2019-2020 Research Week Abstract Book](https://issuu.com/georgina.osorio/docs/1st_annual_mount_sinai_morningside__f91ffc12fb7eb1?fr=sNzQ1MzE0NzM3MDY)