Effects of antiepileptic drugs on lipids, homocysteine, and C‐reactive protein

Mintzer, Scott; Skidmore, Christopher; Abidin, Caitlin J.; Morales, Megan C.; Chervoneva, Inna; Capuzzi, David M.; Sperling, Michael R.

doi:10.1002/ana.21615

Cited by 197 publications

(213 citation statements)

References 36 publications

(57 reference statements)

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“…For example, they alter lipid profile, increasing serum cholesterol levels (Mintzer et al., 2009). However, there is a lack of information about the prevalence of dyslipidemia related to the use of AEDs, which would facilitate appropriate management to reduce the risk of vascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of cardiovascular risk factors in people with epilepsy

et al. 2016

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ObjectivesEpilepsy has been associated with cardiovascular comorbidity. This study aimed to assess the potential association between cardiovascular risk factors (CRFs), antiepileptic drugs (AEDs), and etiology.Material and MethodsA single‐center retrospective epilepsy cohort from the decade of 2004–2013 was assessed. Poisson regression models with robust variance were estimated to obtain CRF prevalence ratios (PR) according to AED prescription and etiology.ResultsAfter excluding patients in the monotherapy group with vascular etiology or previous cardiovascular events, in the remaining 400 patients, enzyme‐inducer AEDs (EIAEDs), especially phenytoin (PHT), were associated with higher prevalence of dyslipidemia (PRa 1.77, p < .05), compared to valproic acid. No etiology was associated with higher prevalence of any CRF.ConclusionsPatients treated with EIAEDs, especially PHT, had higher prevalence of dyslipidemia.

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Section: Introductionmentioning

confidence: 99%

Prevalence of cardiovascular risk factors in people with epilepsy

et al. 2016

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“…This result goes hand in hand with many studies [30] reported reduction of CRP level in patients treated with VPA, in agreement with Mintzer [31] who also reported that patients who were switched from inducing to non-inducing agents had marked reductions in CRP. This suggests that CYP450 induction may be responsible for CRP level increase [32].…”

Section: Discussionmentioning

confidence: 93%

The Predictors of Early Atherosclerosis in Young Adult Epileptic Patients

Soliman

Yousef

Fattah

et al. 2016

Zagazig University Medical Journal

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Background: Patients with epilepsy develope a wide range of medical and neurologic disorders, compared with the general population. The association between epilepsy and atherosclerosis is not clearly defined. Several studies claims that epileptic patients may have the risk to develop atherosclerosis. Methods: This study included 40 adult epileptic and 40 control subjects. For all, Common carotid artery intima media thickness (CA-IMT), fasting lipid profile, serum uric acid (SUA), C -reactive protein (CRP) and glutathione peroxidase (GPX), were assessed. Results: Total cholesterol (TC) ,low density lipoproteins (LDL), Total Triglycerides (TG) ,CRP, GPX were significantly higher in patients compared to control. CA-IMT was significantly higher in epileptic patients treated with antiepileptic drugs (AEDS) compared to control group. The longer the duration of AEDs the thicker was the CA-IMT. Conclusions: Our results heightened atherosclerotic risk in patients with epilepsy on AEDS.

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“…This might be explained by the fact that only a minority of AED users had an epilepsy diagnosis in our cohort and by the difference in methods, where they assessed drug use at 2 time points rather than as a continuous exposure, which makes their results questionable. According to previous studies,23, 24, 25 some AEDs (eg, phenytoin and carbamazepine) seem to induce atherogenic serum cholesterol levels and thus can accelerate atherosclerosis and elevate the risk of cerebrovascular events. However, in our data, the most commonly used AEDs were valproic acid and pregabalin, and they are not known to induce atherosclerosis.…”

Section: Discussionmentioning

confidence: 97%

“…As some AEDs have been linked to accelerated atherosclerosis23, 24, 25 one possibility would have been to assess major adverse cardiovascular events as an outcome. We limited our study to stroke because the aim of this study was to investigate whether AEDs as central nervous system–acting drugs are related to stroke risk in people with AD and because strokes can further accelerate cognitive deterioration in this group.…”

Section: Discussionmentioning

confidence: 99%

Antiepileptic Drug Use and the Risk of Stroke Among Community‐Dwelling People With Alzheimer Disease: A Matched Cohort Study

Sarycheva

Lavikainen

Taipale

et al. 2018

JAHA

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BackgroundPeople with Alzheimer disease (AD) are more predisposed to seizures than older people in general, and use of antiepileptic drugs (AEDs) is more frequent. AED use has been linked to a higher risk of vascular events in the general population; however, it is not evident whether the same risk exists in people with AD. We assessed the risk of stroke associated with incident AED use among people with AD.Methods and ResultsThe MEDALZ (Medication Use and Alzheimer's Disease) cohort includes all Finnish people who received a clinically verified AD diagnosis (N=70718) from 2005 to 2011. People with previous strokes were excluded. For each incident AED user (n=5617) one nonuser was matched according to sex, age, and time since AD diagnosis. Analyses were conducted with Cox proportional hazards models and inverse probability of treatment weighting. Compared with nonuse, AED use was associated with an increased risk of stroke (inverse probability of treatment weighting hazard ratio (HR), 1.37; 95% confidence interval [CI], 1.07–1.74). The risk was strongest during the first 90 days (adjusted HR, 2.36; 95% CI, 1.25–4.47) of AED use. According to stroke type, the association was with ischemic strokes (inverse probability of treatment weighting HR, 1.34; 95% CI, 1.00–1.79) and hemorrhagic ones (inverse probability of treatment weighting HR, 1.44; 95% CI, 0.86–2.43). The stroke risk of users of older AEDs did not differ from that of the users of newer AEDs (adjusted HR, 1.04; 95% CI, 0.71–1.53).Conclusions AED use was related to an increased risk of stroke, regardless of AED type. Our results highlight caution in AED use in this vulnerable population.

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Effects of antiepileptic drugs on lipids, homocysteine, and C‐reactive protein

Cited by 197 publications

References 36 publications

Prevalence of cardiovascular risk factors in people with epilepsy

Prevalence of cardiovascular risk factors in people with epilepsy

The Predictors of Early Atherosclerosis in Young Adult Epileptic Patients

Antiepileptic Drug Use and the Risk of Stroke Among Community‐Dwelling People With Alzheimer Disease: A Matched Cohort Study

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