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Review: people with schizophrenia or other mental illnesses have a lower rate of invasive coronary interventions after acute coronary syndrome

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Question

Question

Are there inequalities in the provision of invasive coronary procedures and mortality from acute coronary syndromes in people with mental illness compared with people without mental illness?

Outcomes

Receipt of any invasive coronary procedures (revascularisation, angiography angioplasty or bypass grafting) and death rate (1-year outcomes included in analysis if available, otherwise 30-day rates included).

Methods

Design

Systematic review and meta-analysis.

Data sources

MEDLINE/PubMed, EMBASE, ScienceDirect, Ingenta Connect, SpringerLink and Wiley Online Library, Web of Knowledge and Scopus were searched from start date to 20 July 2010. To identify additional studies, key journals were hand searched and experts were contacted.

Study selection and analysis

The review included comparative studies of patients with acute coronary syndromes with data on rates of subsequent invasive coronary procedures or mortality, which reported separate data for those with mental and without mental ill health. Studies looking at people with severe mental illness (SMI) were only included where there was a subgroup of people with schizophrenia. Random effects meta-analysis that was used as heterogeneity in the analyses was high (as measured by the I2 statistic). Results were only pooled for analyses …

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