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Antiepileptic drugs and the risk of ischaemic stroke and myocardial infarction: a population-based cohort study.

Renoux C, Dell'Aniello S, Saarela O, Filion KB, Boivin JF - BMJ Open (2015)

Bottom Line: However, current use of inducing AEDs for ≥ 24 months was associated with a 46% increased risk of MI (RR=1.46, 95% CI 1.15 to 1.85) compared with the same duration of non-inducing AED, corresponding to a risk difference of 1.39/1000 (95% CI 0.33 to 2.45) persons per year.Current use of inhibiting AED was associated with a decreased risk of MI (RR=0.81, 95% CI 0.66 to 1.00).In contrast, use of inhibiting AEDs was associated with a decreased risk of MI.

View Article: PubMed Central - PubMed

Affiliation: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada.

No MeSH data available.


Related in: MedlinePlus

Details of cohorts definition. AED, antiepileptic drug; CPRD, Clinical Practice Research Datalink; MI, myocardial infarction; UTS, up-to-standard.
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BMJOPEN2015008365F1: Details of cohorts definition. AED, antiepileptic drug; CPRD, Clinical Practice Research Datalink; MI, myocardial infarction; UTS, up-to-standard.

Mentions: Of the 440 191 patients with at least one AED prescription, 237 050 were eligible for the stroke cohort and 241 405 for the MI cohort (figure 1). The mean age at cohort entry in the stroke cohort was 56.1 (SD=17.5) years; 39.9% were males; and indications for AED prescription were epilepsy (13.5%), pain (49.8%), psychiatric disorders (5.3%) and others/unknown (31.4%). Characteristics were virtually the same in the cohort for studying MI. The mean duration of follow-up was 4.1 years (SD=3.9) in both cohorts, during which 4535 patients were diagnosed with ischaemic stroke and 3636 with MI, yielding overall incidence rates of 4.62 (95% CI 4.49 to 4.75) and 3.63 (95% CI 3.51 to 3.75) per 1000 persons per year, respectively. The characteristics of the cases of ischaemic stroke and MI and their matched controls are presented in table 1. As expected, cases had a higher prevalence of vascular risk factors and comorbidities than controls.


Antiepileptic drugs and the risk of ischaemic stroke and myocardial infarction: a population-based cohort study.

Renoux C, Dell'Aniello S, Saarela O, Filion KB, Boivin JF - BMJ Open (2015)

Details of cohorts definition. AED, antiepileptic drug; CPRD, Clinical Practice Research Datalink; MI, myocardial infarction; UTS, up-to-standard.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4538287&req=5

BMJOPEN2015008365F1: Details of cohorts definition. AED, antiepileptic drug; CPRD, Clinical Practice Research Datalink; MI, myocardial infarction; UTS, up-to-standard.
Mentions: Of the 440 191 patients with at least one AED prescription, 237 050 were eligible for the stroke cohort and 241 405 for the MI cohort (figure 1). The mean age at cohort entry in the stroke cohort was 56.1 (SD=17.5) years; 39.9% were males; and indications for AED prescription were epilepsy (13.5%), pain (49.8%), psychiatric disorders (5.3%) and others/unknown (31.4%). Characteristics were virtually the same in the cohort for studying MI. The mean duration of follow-up was 4.1 years (SD=3.9) in both cohorts, during which 4535 patients were diagnosed with ischaemic stroke and 3636 with MI, yielding overall incidence rates of 4.62 (95% CI 4.49 to 4.75) and 3.63 (95% CI 3.51 to 3.75) per 1000 persons per year, respectively. The characteristics of the cases of ischaemic stroke and MI and their matched controls are presented in table 1. As expected, cases had a higher prevalence of vascular risk factors and comorbidities than controls.

Bottom Line: However, current use of inducing AEDs for ≥ 24 months was associated with a 46% increased risk of MI (RR=1.46, 95% CI 1.15 to 1.85) compared with the same duration of non-inducing AED, corresponding to a risk difference of 1.39/1000 (95% CI 0.33 to 2.45) persons per year.Current use of inhibiting AED was associated with a decreased risk of MI (RR=0.81, 95% CI 0.66 to 1.00).In contrast, use of inhibiting AEDs was associated with a decreased risk of MI.

View Article: PubMed Central - PubMed

Affiliation: Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada Department of Epidemiology and Biostatistics, McGill University, Montréal, Québec, Canada.

No MeSH data available.


Related in: MedlinePlus