Neurology
Epilepsy emerging later in life may signal systemic vascular vulnerability beyond the brain
Study details: The Northern Manhattan Study followed 3,174 stroke-free adults (mean age, 69 years; 63.5% women) for up to 30 years. Researchers assessed whether MI increases risk for LOE and whether LOE predicts MI and nonstroke vascular death, using Cox models adjusted for demographics, behaviors, and comorbidities.
Results:
- After MI, LOE incidence was 7.02 vs. 2.49 per 1,000 person-years without MI (adjusted hazard ratio [aHR], 2.12; 95% confidence interval [CI], 1.06–4.25).
- After LOE, MI incidence was 17.68 vs. 6.46 per 1,000 person-years without LOE (aHR, 1.99; 95% CI, 0.98–4.05).
- Nonstroke vascular death after LOE: 99.24 vs. 16.29 per 1,000 person-years without LOE (aHR, 2.82; 95% CI, 2.09–3.80).
Clinical impact: LOE and MI show bidirectional associations, and LOE strongly predicts vascular mortality. Clinicians should consider LOE as a potential marker of systemic vascular risk and monitor cardiovascular health in patients with new-onset epilepsy.
Source:
Thacker EL, et al. (2025, December 9). Neurology. Associations of Late-Onset Epilepsy With Myocardial Infarction and Nonstroke Vascular Death. https://pubmed.ncbi.nlm.nih.gov/41191854/