The effects on carotid artery intima-media wall thickness and development of atherosclerosis in children on anti-epileptic drug monotherapy

Ksoo, Rosina; Sharma, Rakesh; Kaushal, R.; Jhobta, Anupam

doi:10.18203/2349-3291.ijcp20172668

Cited by 3 publications

(12 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…32 Contrary to our findings, Ksoo et al reported that CIMT was not significantly increased in patients receiving CBZ and VPA compared to controls. 25 In our study, we reported significant changes in lipid profile including TC, TG, LDL, HDL, and Apo A1 in children with epilepsy who received valproate and carbamazepine compared to levetiracetam and controls. Our results are consistent with previous studies that reported dyslipidemia with long-term AED therapy with elevation in the serum levels of TC and LDL.…”

Section: Discussionmentioning

confidence: 52%

“…The gender distribution and clinical characteristics of our patients were comparable to other studies. 4,25 Our study showed the difference in BMI between cases and controls was not statistically significant (P >.05). Contrary to our results, El-Farahaty et al, found a significantly higher BMI among cases receiving valproate and levetiracetam compared to controls (P = .003).…”

Section: Discussionmentioning

confidence: 63%

“…However, no significant difference in the mean CIMT between males and females as reported in other studies. 25,32 In a recent study conducted by Kolekar et al, they studied 42 epileptic children between 1 and 18 years of age over 18 months receiving AED monotherapy with valproate, phenytoin, or levetiracetam for at least 6 months. They reported significant abnormalities in CIMT with these AEDs.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The Study of Carotid Artery Intima-Media Thickness in Children With Epilepsy on Anti-Epileptic Drugs

Nasef,

Elmala,

Sayed Ahmed

et al. 2023

Global Pediatric Health

View full text Add to dashboard Cite

Objectives. To evaluate carotid artery intima-media thickness (CIMT) and lipid profile in children with epilepsy on long-term antiepileptic drug (AED) monotherapy. Methods. We included 60 children with epilepsy receiving valproate, carbamazepine, or levetiracetam monotherapy and 60 controls. A high-resolution B-mode ultrasound was used to measure (CIMT). Measurement of serum lipids was done. Results. Patients on valproate (0.44 ± 0.03, P ≤ .001), carbamazepine (0.43 ± 0.03with P ≤ .001), and levetiracetam (0.44 ± 0.02 with P ≤ .001) monotherapy showed significantly higher CIMT compared to controls. CIMT was correlated with age ( P = .041, r = .112) AEDs{valproate ( P = .005, r = .731), carbamazepine ( P = .038, r = .365), and levetiracetam ( P = .036, r = .155)}, duration of treatment ( P = .001, r = .313), TC( P = .001, r = .192), TG ( P = .014, r = .018), and LDL ( P = .001, r = .219). HDL ( P = .003, r = −.126). Seizure severity and Apo A1 were insignificantly involved. Conclusion. Long-term monotherapy with valproate, carbamazepine, and levetiracetam in epileptic children was associated with significant abnormalities in CIMT.

show abstract

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Study of Carotid Artery Intima-Media Thickness in Children With Epilepsy on Anti-Epileptic Drugs

Nasef,

Elmala,

Sayed Ahmed

et al. 2023

Global Pediatric Health

View full text Add to dashboard Cite

show abstract

“…CIMT was significantly higher in patients receiving multidrug and valproate compared to the control group, with no difference in the LEV group. Ksoo et al 33 illustrated a significant increase in CIMT values in children receiving PHT and CBZ after 3 months of therapy. Recent studies showed that patients with epilepsy who received AEDs might exhibit an increased risk of myocardial infarction, stroke, and cardiovascular death that may be triggered by affecting ADMA and homocysteine concentration and serum lipid levels.…”

Section: Discussionmentioning

confidence: 97%

Assessment of asymmetric dimethylarginine and homocysteine in epileptic children receiving antiepileptic drugs

et al. 2022

View full text Add to dashboard Cite

Background Epilepsy is a neurological disease that requires long-term antiepileptic drugs (AEDs). The old generation of AEDs may affect serum homocysteine and asymmetric dimethylarginine (ADMA) and disturb lipid levels. The aim of the study was to evaluate serum ADMA, homocysteine, lipid profile, and carotid intima-media thickness (CIMT) in epileptic children. Methods This study was implemented on 159 epileptic children who were subdivided into 3 subgroups, with 53 receiving sodium valproate, 53 receiving levetiracetam, and 53 receiving polytherapy, for over 6 months and 53 healthy children. Results Low-density lipoprotein, triglycerides, and cholesterol levels were increased in epileptic children (p < 0.001), which were higher in those receiving multidrug followed by a valproate receiver. While high-density lipoprotein was lower in those receiving multidrug more than those receiving valproate. ADMA and homocysteine levels increased in epileptic patients than in controls (p < 0.001). Higher ADMA was also observed in the multidrug receiver (5.78 ± 0.62), followed by the levetiracetam group (5.56 ± 0.61). Homocysteine levels were significantly higher in multidrug and valproate-treated children than those treated with levetiracetam. CIMT was significantly higher in multidrug and valproate-treated patients (p < 0.001). Conclusions Long-term use of AEDs, especially old-generation polytherapy, can elevate lipid profiles, homocysteine, ADMA levels, and carotid intima-media thickness compared to the minimal effect of new AEDs. Impact The long-term use of antiepileptic drugs, especially old-generation polytherapy, can increase lipid profiles, homocysteine levels, ADMA, and carotid intima thickness compared to the minimal effect of new antiepileptic generation. A routine follow-up of these markers and a lifestyle modification are recommended to avoid cerebrovascular events as much as possible.

show abstract

“…Chronic exposure to these drugs can disturb the oxidative balance, triggering oxidative stress. This condition will lead to endothelial cells damage, which in turn causes atherosclerosis [4], [6], [7]. As a result, the mortality rate increases which is associated with cardiovascular risk in epileptic patients who receive long-term therapy.…”

Section: Introductionmentioning

confidence: 99%

The Correlation between Old-Generation Antiepileptic Drugs Usage with Carotid Intima-Media Thickness in Epilepsy Patient

Permana¹,

Sutia²,

Susanti³

et al. 2019

Proceedings of the Proceedings of the 1st EAI International Conference on Medical and Health Research, ICoMHER November 13-14th

View full text Add to dashboard Cite

Epilepsy is one of the neurological disorders that quite common, which about 50 million people worldwide affected each year. Most of the epilepsy patients need longterm therapy, and old-generation of antiepileptic is often used as monotherapy. Long-term usage of antiepileptic drugs plays an important role in the pathogenesis of atherosclerosis. The incidence of atherosclerosis can be estimated by the thickness of tunica intima-media carotid artery. This study aimed to evaluate the correlation between long-term usage of old-generation antiepileptic drugs and the carotid intima-media thickness. We conducted a cross-sectional study in DR. M. Djamil Hospital, Padang, between March until August 2018. A total of 26 epilepsy patients were recruited. Those with the cardiovascular risk factor, the subject who did not undergo treatment regulary were excluded. The carotid intima-media thickness was measured by EPIQ7 Ultrasound systems Machine. The relationship between variables was analyzed using Kendall's tau test b, and p-value <0.05 was considered to be statistically significant. Most subjects received phenytoin as their regular AED (76.92%), while 4 subjects received Carbamazepine (15.38%) and 1 subject received phenobarbital (3.84%), and the other drugs (3.84%). The mean duration of therapy was 2.88 years. There is no correlation between long-term usage of AEDs and carotid intima-media thickness in epileptic patients (p=0.052). There was no significant correlation between long-term old-generation usage of antiepileptic drug and carotid intima-media thickness.

show abstract

The effects on carotid artery intima-media wall thickness and development of atherosclerosis in children on anti-epileptic drug monotherapy

Cited by 3 publications

References 18 publications

The Study of Carotid Artery Intima-Media Thickness in Children With Epilepsy on Anti-Epileptic Drugs

The Study of Carotid Artery Intima-Media Thickness in Children With Epilepsy on Anti-Epileptic Drugs

Assessment of asymmetric dimethylarginine and homocysteine in epileptic children receiving antiepileptic drugs

The Correlation between Old-Generation Antiepileptic Drugs Usage with Carotid Intima-Media Thickness in Epilepsy Patient

Contact Info

Product

Resources

About