Assessment of cardiovascular risk via atherogenic indices in patients with bipolar disorder manic episode and alterations with treatment

Objectives: Cardiovascular disease is one of the important cause of mortality among patients with Bipolar Disorder. Castelli Risk index I and II (CRI-I and II), Atherogenic Index of Plasma (AIP) and Atherogenic coefficient (AC) are new parameters in assessing cardiovascular risk. In this study we aimed to explore the status of cardiovascular risk factors and their alterations with treatment in manic episode.

Methods: Bipolar Disorder inpatients who were in manic episode and age-gender matched healthy controls were included in the study. CRI-I, CRI-II, AIP and AC parameters were calculated before and after treatment. The statistical significance level was accepted as p<0.05.

Results: Sixty-eight male patients and 60 healthy controls were included in the study. CRI-I, CRI-II, AIP and AC parameters showed an increase after treatment (p<0.001 for all parameters). There was no significant difference between patients and controls in terms of CRI-I and CRI-II and AC (p=0.129, p=0.573, p=0.129 respectively). Although mean AIP levels of patients was significantly lower than control group (p=0.031), the significance disappeared when we compared the patients and controls according to being in low, medium, and high risk groups (χ2=0.826, p=0.662).

Conclusions: Even in short term of treatment, antipsychotics have an important role in developing dyslipidemia and increasing cardiovascular risk. Manic state may have positive or at least no additional influences on atherogenic risk.