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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

Adjusted rate ratios of ischaemic stroke and myocardial infarction associated with current use of inducing and inhibiting AEDs compared with non-inducing AEDs using different methods of adjustment. AED, antiepileptic drug; HDPS, high-dimensional propensity scores; IE, inducing AED; INHE, inhibiting AED; NIE, non-inducing AED; PS, propensity scores; RR, rate ratio.
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BMJOPEN2015008365F4: Adjusted rate ratios of ischaemic stroke and myocardial infarction associated with current use of inducing and inhibiting AEDs compared with non-inducing AEDs using different methods of adjustment. AED, antiepileptic drug; HDPS, high-dimensional propensity scores; IE, inducing AED; INHE, inhibiting AED; NIE, non-inducing AED; PS, propensity scores; RR, rate ratio.

Mentions: Restricting the exposure time window to 30 days did not affect the adjusted RRs of ischaemic stroke and MI estimated in the primary analysis (data not shown). Similarly, measuring covariates at cohort entry rather than 1–2 years before the index date, or controlling for confounding with PS or hdPS, did not materially change our results (figure 4). Restricting the analysis to ischaemic stroke only, that is, excluding strokes not otherwise specified, or using multiple imputations for missing data on smoking and body mass index, yielded similar estimates. Finally, adding dementia to the list of adjustment covariates and removing adjustment for transient ischaemic attack or coronary heart disease during follow-up resulted in very similar estimates.


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)

Adjusted rate ratios of ischaemic stroke and myocardial infarction associated with current use of inducing and inhibiting AEDs compared with non-inducing AEDs using different methods of adjustment. AED, antiepileptic drug; HDPS, high-dimensional propensity scores; IE, inducing AED; INHE, inhibiting AED; NIE, non-inducing AED; PS, propensity scores; RR, rate ratio.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

BMJOPEN2015008365F4: Adjusted rate ratios of ischaemic stroke and myocardial infarction associated with current use of inducing and inhibiting AEDs compared with non-inducing AEDs using different methods of adjustment. AED, antiepileptic drug; HDPS, high-dimensional propensity scores; IE, inducing AED; INHE, inhibiting AED; NIE, non-inducing AED; PS, propensity scores; RR, rate ratio.
Mentions: Restricting the exposure time window to 30 days did not affect the adjusted RRs of ischaemic stroke and MI estimated in the primary analysis (data not shown). Similarly, measuring covariates at cohort entry rather than 1–2 years before the index date, or controlling for confounding with PS or hdPS, did not materially change our results (figure 4). Restricting the analysis to ischaemic stroke only, that is, excluding strokes not otherwise specified, or using multiple imputations for missing data on smoking and body mass index, yielded similar estimates. Finally, adding dementia to the list of adjustment covariates and removing adjustment for transient ischaemic attack or coronary heart disease during follow-up resulted in very similar estimates.

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