Title:
Integrated Community Cardiac Clinic for the Assessment of Cardiovascular Disease in Severely Mentally Ill Patients

Authors:
Sudip Ghosh, Samantha Harrison, Caroline Moseley, Emma Goulding, Julie Read, United Kingdom

Abstract:

Cardiovascular disease (CVD) accounts for ~20% of physical comorbidity amongst people diagnosed with severe mental illness (SMI), and people of all ages have reduced life expectancy compared to the general population.

69 patients on our SMI register were invited to attend a one-stop cardiac assessment clinic in the general practice setting between June 2021 and March 2022. The consultation included a CV risk assessment which consisted of detailed CV history and examination including10 year CV risk assessment, blood panel work-up and electrocardiography (ECG).

42 patients (61%) attended the clinics. Mean age of the patients were 38.9 ± 3.9 years (range 22-63). The mean 10 year-CV risk using the QRISK2 tool was 11.4 ± 6.7%. Only 5 patients were on statin therapy at presentation in clinic. 24 patients (57%) were diabetic with mean HbA1c of 53 ± 2.7 Mmol/L. 39 out of the 42 patients smoked. Mean body mass index was 34.5 ± 1.9 with mean blood pressure at 132 ± 13/ 87 ± 21 mmHg. Mean LDL was 2.9 ± 1.1 mg/dl. 6 patients reported ECG abnormalities suggestive of ischaemic changes and were referred to cardiology for further work-up. 2 patients have now undergone percutaneous coronary intervention with stent placement and the remaining 4 patients are receiving medical management. All patients with high QRISK2 scores have been offered statin therapy.

Given the shortened life span of people with SMI, and the considerable contribution of CVD to earlier mortality, the data support more thorough screening and effective management of major cardiovascular risk factors within the community setting.

DOI: http://dx.doi.org/10.51505/ijmshr.2023.7405