Epilepsy-Heart Syndrome: Incidence and Clinical Outcomes of Cardiac Complications in patients with Epilepsy

Bucci, Tommaso ORCID: 0000-0003-2895-6234, Mbizvo, G ORCID: 0000-0002-9588-2944, Rivera-Caravaca, José Miguel ORCID: 0000-0003-0492-6241, Mayer, J, Marson, A ORCID: 0000-0002-6861-8806, Abdul Rahim, Azmil Husin ORCID: 0000-0002-1318-4027 and Lip, Gregory ORCID: 0000-0002-7566-1626 (2023) Epilepsy-Heart Syndrome: Incidence and Clinical Outcomes of Cardiac Complications in patients with Epilepsy. Current Problems in Cardiology, 48 (10). 101868-.

Text Manuscript.docx - Author Accepted Manuscript Download (116kB)

Abstract

The risks of cardiovascular events (CVEs) in people with epilepsy (PWE) are not well understood. To establish the short- and long-term burden of CVEs in PWE. Electronic health records from a global federated health research network (TriNetX) were used to establish a cohort of PWE. Primary outcomes were: (1) the proportion of people experiencing a composite outcome of cardiac arrest, acute heart failure (HF), acute coronary syndrome (ACS), atrial fibrillation (AF), severe ventricular arrhythmia or all-cause death within 30 days of a seizure; and (2) the 5-year risk for a composite outcome of ischemic heart diseases, stroke, hospitalization, or all-cause death in the PWE experiencing early CVEs. Cox-regression analyses with propensity score matching was used to produce hazard ratios (HRs) and 95% confidence intervals (CI). In 271,172 PWE (mean age 50 ± 20 years; 52% females), the 30-day risk of CVEs following seizure was: 8.7% for the composite outcome, 0.9% for cardiac arrest, 0.8% for HF, 1.2% for ACS, 4.1% for AF, 0.7% for severe ventricular arrhythmias, and 1.6% for all-cause death. For the 15,120 PWE experiencing CVEs within 30 days of seizure, the 5-year adjusted risks for all composite outcomes measured were significantly increased (overall HR: 2.44, 95% CI 2.37-2.51), ischemic heart diseases HR 3.23 (95% CI 3.10-3.36), stroke HR 1.56 (95% CI 1.48-1.64), hospitalization HR 2.03 (95% CI 1.97-2.10), and all-cause death HR 2.75 (95% CI 2.61-2.89). The large proportions of PWE with active disease that experience CVEs and the poor long-term outcome associated suggest the existence of an "epilepsy-heart syndrome."

Item Type:	Article
Uncontrolled Keywords:	Humans, Epilepsy, Seizures, Atrial Fibrillation, Heart Arrest, Incidence, Risk Factors, Adult, Aged, Middle Aged, Female, Male, Heart Failure, Stroke, Acute Coronary Syndrome
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	07 Jun 2023 08:24
Last Modified:	28 Dec 2023 23:13
DOI:	10.1016/j.cpcardiol.2023.101868
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3170847