Certain antiseizure medications linked to CV events in older people

Epilepsy was associated with new-onset cardiovascular events (CVEs) in older adults, with nearly one third of this association explained by enzyme-inducing antiseizure medications (EIASMs).

Study

This prospective cohort study used the comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA), with 6 years of follow-up. CLSA, an ongoing, national study of 51,338 adults ages 45 to 85 years at baseline, includes 30,097 individuals living near 1 of 11 data collection centers.

Results

A total of 27,230 individuals (mean age, 62.3 years) in the comprehensive cohort were included, 431 of whom had a lifetime history of epilepsy, and none had prior history of CVEs (i.e., stroke, TIA, or MI). New-onset CVEs were significantly more likely in individuals with epilepsy, with an adjusted odds ratio of 2.20 (95% CI, 1.48-3.27). Mediation analysis showed the following contributions to the effect of epilepsy on new-onset CVEs: strong EIASM use, 24.6% (95% CI, 6.5%-54.6%), weak EIASM use, 4.0% (95% CI, 0.8%-11.0%), Framingham score, 1.4% (95% CI, -1.6% to 4.5%), Physical Activity Scale for the Elderly score, 3.3% (95% CI, 1.4%-6.8%), and waist-to-hip ratio, 1.6% (95% CI, 0.4%-3.7%).

Meaning

These findings should be considered when choosing an antiseizure medication for a patient at risk for CVD.

Source:

Li J, et al. (2024, September 30). JAMA Neurol. Antiseizure Medications and Cardiovascular Events in Older People With Epilepsy. https://pubmed.ncbi.nlm.nih.gov/39348143/