Epilepsy and long-term risk of arrhythmias

被引：31

作者：

Wang, Jie ^{[1
,2
]}

Huang, Peiyuan ^{[3
]}

Yu, Qingwei ^{[1
,4
]}

Lu, Jun ^{[1
]}

Liu, Pinbo ^{[1
]}

Yang, Yiping ^{[1
]}

Feng, Zeying ^{[1
]}

Cai, Jingjing ^{[1
,2
]}

Yang, Guoping ^{[1
]}

Yuan, Hong ^{[1
,2
]}

Tang, Haibo ^{[5
]}

Lu, Yao ^{[1
,2
,6
]}

机构：

[1] Cent South Univ, Xiangya Hosp 3, Clin Res Ctr, 138 Tongzipo Rd, Changsha 410013, Hunan, Peoples R China

[2] Cent South Univ, Xiangya Hosp 3, Dept Cardiol, 138 Tongzipo Rd, Changsha 410013, Hunan, Peoples R China

[3] Univ Bristol, Bristol Med Sch, MRC Integrat Epidemiol Unit IEU, Oakfield House, Bristol BS8 2BN, England

[4] Cent South Univ, Xiangya Hosp, Dept Neurosurg, 87 Xiangya Rd, Changsha 410008, Hunan, Peoples R China

[5] Cent South Univ, Xiangya Hosp 3, Dept Metab & Bariatr Surg, Changsha 410013, Hunan, Peoples R China

[6] Kings Coll London, Fac Life Sci & Med, 150 Stamford St, London SE1 9NH, England

来源：

EUROPEAN HEART JOURNAL | 2023年 / 44卷 / 35期

基金：

英国惠康基金; 中国国家自然科学基金;

关键词：

Epilepsy; Cardiac arrhythmias; Carbamazepine; Valproic acid; Atrial fibrillation; TONIC-CLONIC SEIZURES; SUDDEN CARDIAC DEATH; CARDIOMYOPATHY; CARBAMAZEPINE; MANAGEMENT; HISTORY; DISEASE; HEART;

D O I：

10.1093/eurheartj/ehad523

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background and Aims Previous evidence has mainly supported transient changes in cardiac function during interictal or peri-ictal phases in people with epilepsy, but the long-term risk of cardiac arrhythmias is poorly described. This study aimed to assess the long-term association of epilepsy with cardiac arrhythmias, considering the potential role of genetic predisposition and antiseizure medications (ASMs) in any associations observed. Methods This population-based study evaluated UK Biobank data for individuals recruited between 2006 and 2010. Cox proportional hazards models and competing risk models were used to examine the association of epilepsy history with the long-term incidence risk of cardiac arrhythmias and arrhythmias subtypes. Polygenic risk scores (PRS) were calculated to investigate the effect of genetic susceptibility. The role of ASMs was also evaluated by integrating observational and drug target Mendelian randomization (MR) evidence. Results The study included 329 432 individuals, including 2699 people with epilepsy. Compared with those without epilepsy, people with epilepsy experienced an increased risk of all cardiac arrhythmias [hazard ratio (HR) 1.36, 95% confidence interval (CI) 1.21-1.53], atrial fibrillation (HR 1.26, 95% CI 1.08-1.46), and other cardiac arrhythmias (HR 1.56, 95% CI 1.34-1.81). The associations were not modified by genetic predisposition as indicated by PRS. Competing and sensitivity analyses corroborated these results. Individuals with epilepsy using ASMs, especially carbamazepine and valproic acid, were at a higher risk for cardiac arrhythmias. This observation was further supported by drug target MR results (P-SMR < .05 and P-HEIDI > .05). Conclusion This study revealed the higher risk of cardiac arrhythmias persists long term in people with epilepsy, especially among those using carbamazepine and valproic acid. These findings highlight the need for regular heart rhythm monitoring and management in people with epilepsy in order to reduce the risk of further cardiovascular complications.

引用

页码：3374 / 3382

页数：9

共 47 条

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