Bipolar Disorder and Acute Myocardial Infarction Hospitalizations: Administrative data analysis

Abstract

Background: Bipolar disorder (BD) is associated with a substantial decrease in life expectancy and high rates of medical comorbidity, including acute myocardial infarction (AMI). This study aims to investigate the association between BD and AMI by evaluating the differences in in-hospital mortality, treatment, AMI presentation, and cardiovascular risk factors. Methods: A retrospective observational study analysed hospitalizations for AMI in Portugal from 2008 to 2015, dividing patients into BD and non-BD groups. Key outcomes, such as age, AMI presentation, revascularization, and in-hospital mortality, were assessed using chi-square, t-tests, and Mann-Whitney U tests. Results: A total of 99382 patients were included in the analysis, of which 109 (0,1%) had BD. Hospitalizations with comorbid BD were associated with younger patients (60,71 vs 68,58). Regarding the type of procedures, we found a higher rate of Coronary Artery Bypass Graft (CABG) procedures in the BD group (5,5% vs 1,8%) but no significant differences in revascularization in general. Tobacco use register was significantly higher in people with BD (51,4% vs 26,5%). No differences were found regarding in-hospital mortality. Limitations: In addition to the inherent limitations of a retrospective study, the data used was collected for administrative reasons and not for clinical or research purposes. Despite the numerous hospitalization episodes in the database, few cases of BD are recorded. Conclusions: In our study, patients with registered BD had AMI at a younger age. We did not find an association between BD and lower revascularization procedure rates or higher mortality. There was also no difference regarding AMI presentation between both groups.