Kelly Fleetwood, John Nolan, Colin Berry, Debbie Cavers, Stewart W Mercer, Sandosh Padmanabhan, Daniel J Smith, Robert Stewart, Amanda Vettini, Caroline A Jackson, on behalf of the CVD-COVID-UK/COVID-IMPACT Consortium
Severe mental illness (SMI), which includes schizophrenia, bipolar disorder and major depression, affects roughly one in ten adults every year in the United Kingdom. People with SMI die 10-20 years earlier than people without SMI. This is mainly due to poorer physical health, in particular a higher risk of cardiovascular disease (CVD), including myocardial infarction (MI).
After an MI, people with SMI are more likely to die than those without SMI. The reasons for this difference in outcome remain unclear and require deeper investigation, including to determine the role of confounding variables such as key comorbidities, as well as the role of receipt of care. The contribution of the latter to the difference in mortality outcome has not yet been explored in depth. Furthermore, we do not know whether any differences in risk of dying after an MI have been affected by the COVID-19 pandemic. It is important to investigate this, to inform responses to this now and in future situations where disruptions of care occur.
This protocol describes the methods we will use to examine SMI and mortality following MI. Separate protocols address SMI and receipt of acute cardiac care following MI (CCU046_01) and incidence of MI, stroke and heart failure by SMI (CCU046_03).
Preprint available here: https://doi.org/10.1101/2025.11.21.25340653
- View the analysis code used in NHS England's SDE for England
- View the phenotyping algorithms and codelists used in NHS England's SDE for England
This is a sub-project of project CCU046 approved by the CVD-COVID-UK / COVID-IMPACT Approvals & Oversight Board (sub-project: CCU046_02).
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