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

Mayer, Josephine, Fawzy, Ameenathul M, Bisson, Arnaud, Pasi, Marco, Bodin, Alexandre, Vigny, Pascal, Herbert, Julien, Marson, Anthony G ORCID: 0000-0002-6861-8806, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Fauchier, Laurent (2024) Epilepsy and the risk of adverse cardiovascular events: A nationwide cohort study. European journal of neurology, 31 (3). e16116-.

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Official URL: http://dx.doi.org/10.1111/ene.16116

Abstract

<h4>Background and purpose</h4>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).<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.

Item Type:	Article
Uncontrolled Keywords:	Humans, Brain Ischemia, Epilepsy, Heart Arrest, Risk Factors, Retrospective Studies, Cohort Studies, Longitudinal Studies, Cross-Sectional Studies, Heart Failure, Stroke, Ischemic Stroke
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	12 Feb 2024 09:04
Last Modified:	14 Feb 2024 19:44
DOI:	10.1111/ene.16116
Open Access URL:	https://onlinelibrary.wiley.com/doi/10.1111/ene.16...
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3178603