Epilepsy and the risk of adverse cardiovascular events: A nationwide cohort study.

Autor: Mayer J; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK.; Walton Centre NHS Foundation Trust, Department of Pharmacology and Therapeutics, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, UK., Fawzy AM; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK., Bisson A; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK.; Department of Cardiology, Tours Regional University Hospital, Hospital Trousseau, Tours, France., Pasi M; Department of Neurology, Hospital Bretonneau, Tours, France., Bodin A; Department of Cardiology, Tours Regional University Hospital, Hospital Trousseau, Tours, France., Vigny P; Clinical Data Centre, Public Health and Prevention Unit, Tours University Hospital, Tours, France., Herbert J; Clinical Data Centre, Public Health and Prevention Unit, Tours University Hospital, Tours, France., Marson AG; Walton Centre NHS Foundation Trust, Department of Pharmacology and Therapeutics, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, UK., Lip GYH; Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, UK.; Danish Centre for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark., Fauchier L; Department of Cardiology, Tours Regional University Hospital, Hospital Trousseau, Tours, France.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2024 Mar; Vol. 31 (3), pp. e16116. Date of Electronic Publication: 2024 Jan 02.
DOI: 10.1111/ene.16116
Abstrakt: Background and Purpose: Epilepsy is associated with higher morbidity and mortality compared to people without epilepsy. We performed a retrospective cross-sectional and longitudinal cohort study to evaluate cardiovascular comorbidity and incident vascular events in people with epilepsy (PWE).
Methods: Data were extracted from the French Hospital National Database. PWE (n = 682,349) who were hospitalized between January 2014 and December 2022 were matched on age, sex, and year of hospitalization with 682,349 patients without epilepsy. Follow-up was conducted from the date of first hospitalization with epilepsy until the date of each outcome or date of last news in the absence of the outcome. Primary outcome was the incidence of all-cause death, cardiovascular death, myocardial infarction, hospitalization for heart failure, ischaemic stroke (IS), new onset atrial fibrillation, sustained ventricular tachycardia or fibrillation (VT/VF), and cardiac arrest.
Results: A diagnosis of epilepsy was associated with higher numbers of cardiovascular risk factors and adverse cardiovascular events compared to controls. People with epilepsy had a higher incidence of all-cause death (incidence rate ratio [IRR] = 2.69, 95% confidence interval [CI] = 2.67-2.72), cardiovascular death (IRR = 2.16, 95% CI = 2.11-2.20), heart failure (IRR = 1.26, 95% CI = 1.25-1.28), IS (IRR = 2.08, 95% CI = 2.04-2.13), VT/VF (IRR = 1.10, 95% CI = 1.04-1.16), and cardiac arrest (IRR = 2.12, 95% CI = 2.04-2.20). When accounting for all-cause death as a competing risk, subdistribution hazard ratios for ischaemic stroke of 1.59 (95% CI = 1.55-1.63) and for cardiac arrest of 1.73 (95% CI = 1.58-1.89) demonstrated higher risk in PWE.
Conclusions: The prevalence and incident rates of cardiovascular outcomes were significantly higher in PWE. Targeting cardiovascular health could help reduce excess morbidity and mortality in PWE.
(© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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