Patients with epilepsy are at an increased risk of subsequent stroke: A population-based cohort study

被引：74

作者：

Chang, Chen-Shu ^{[1
,2
,3
]}

Liao, Chun-Hui ^{[4
,5
,6
]}

Lin, Che-Chen ^{[7
]}

Lane, Hsien-Yuan ^{[4
,5
,6
]}

Sung, Fung-Chang ^{[5
,6
,7
]}

Kao, Chia-Huang ^{[5
,6
,8
,9
]}

机构：

[1] Changhua Christian Hosp, Dept Neurol, Changhua, Taiwan

[2] Cent Taiwan Univ Sci & Technol, Dept Med Lab Sci & Biotechnol, Taichung, Taiwan

[3] Cent Taiwan Univ Sci & Technol, Taichung, Taiwan

[4] China Med Univ Hosp, Dept Psychiat, Taichung, Taiwan

[5] China Med Univ, Coll Med, Grad Inst Clin Med Sci, Taichung 404, Taiwan

[6] China Med Univ, Coll Med, Sch Med, Taichung 404, Taiwan

[7] China Med Univ, Management Off Hlth Data, Taichung 404, Taiwan

[8] China Med Univ Hosp, Dept Nucl Med, Taichung, Taiwan

[9] China Med Univ Hosp, PET Ctr, Taichung, Taiwan

来源：

SEIZURE-EUROPEAN JOURNAL OF EPILEPSY | 2014年 / 23卷 / 05期

关键词：

Comorbidity; Epilepsy; Stroke; Insurance claims data; Retrospective cohort study; SERUM-LIPID LEVELS; ISCHEMIC-STROKE; VASCULAR RISK; ANTIEPILEPTIC DRUGS; HEALTH-INSURANCE; SOMATIC COMORBIDITY; GENERAL-POPULATION; OXIDATIVE STRESS; VALPROIC ACID; ATHEROSCLEROSIS;

D O I：

10.1016/j.seizure.2014.02.007

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Purpose: Epilepsy is well known as a disorder in poststroke patients. However, studies that have investigated the association between epilepsy and the risk of subsequent stroke are limited. This population-based study investigated the incidence and risk of stroke in patients with epilepsy by using the Taiwan National Health Insurance claims data. Methods: We identified 3812 patients newly diagnosed with epilepsy in 2000-2008 and 15,248 nonepilepsy comparisons frequency matched according to sex, age, and index year. We searched for subsequent stroke diagnoses in both cohorts until the end of 2009. The incidence rates and hazard ratios of stroke were estimated based on sex, age, the average defined daily doses (DDDs) of antiepilepsy drugs, and comorbidity. Results: The stroke incidence of the epilepsy cohort was 3-fold higher than that of the comparison cohort. The age-specific results indicated that in the epilepsy cohort and the comparison cohort, the risk was the highest for the youngest group (20-39 years). Conclusion: The patients with epilepsy exhibited a higher incidence of cerebral stroke than the general population did. In addition, younger patients with epilepsy and patients who took a high doses of antiepileptic drugs exhibited a high risk of stroke. (C) 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

引用

页码：377 / 381

页数：5

共 48 条

[1] Echogenecity of the carotid intima-media complex is related to cardiovascular risk factors, dyslipidemia, oxidative stress and inflammation The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study [J].

Andersson, Jessika ;

Sundstrom, Johan ;

Gustavsson, Thomas ;

Hulthe, Johannes ;

Elmgren, Anders ;

Zilmer, Kersti ;

Zilmer, Mihkel ;

Lind, Lars .

ATHEROSCLEROSIS, 2009, 204 (02) :612-618

[2] Epilepsy and migraine [J].

Bigal, ME ;

Lipton, RB ;

Cohen, J ;

Silberstein, SD .

EPILEPSY & BEHAVIOR, 2003, 4 :S13-S24

[3] Medical comorbidities in the treatment of epilepsy [J].

Boro, A ;

Haut, S .

EPILEPSY & BEHAVIOR, 2003, 4 :S2-S12

[4] Seizures and epilepsy after ischemic stroke [J].

Camilo, O ;

Goldstein, LB .

STROKE, 2004, 35 (07) :1769-1775

[5] CT perfusion improves diagnostic accuracy and confidence in acute ischaemic stroke [J].

Campbell, Bruce C. V. ;

Weir, Louise ;

Desmond, Patricia M. ;

Tu, Hans T. H. ;

Hand, Peter J. ;

Yan, Bernard ;

Donnan, Geoffrey A. ;

Parsons, Mark W. ;

Davis, Stephen M. .

JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2013, 84 (06) :613-618

[6] Seizures are Common in the Acute Setting of Childhood Stroke: A Population-Based Study [J].

Chadehumbe, Madeline A. ;

Khatri, Pooja ;

Khoury, Jane C. ;

Alwell, Kathleen ;

Szaflarski, Jerzy P. ;

Broderick, Joseph P. ;

Kissela, Brett M. ;

Kleindorfer, Dawn O. .

JOURNAL OF CHILD NEUROLOGY, 2009, 24 (01) :9-12

[7] Geographic variation in the age- and gender-specific prevalence and incidence of epilepsy: Analysis of Taiwanese National Health Insurance-based data [J].

Chen, Chih-Chuan ;

Chen, Li-Sheng ;

Yen, Ming-Fang ;

Chen, Hsiu-Hsi ;

Liou, Horng-Huei .

EPILEPSIA, 2012, 53 (02) :283-290

[8] Taiwan's new national health insurance program: Genesis and experience so far [J].

Cheng, TM .

HEALTH AFFAIRS, 2003, 22 (03) :61-76

[9] Taiwan's 1995 health care reform [J].

Chiang, TL .

HEALTH POLICY, 1997, 39 (03) :225-239

[10] Effects of long-term antiepileptic drug monotherapy on vascular risk factors and atherosclerosis [J].

Chuang, Yao-Chung ;

Chuang, Hung-Yi ;

Lin, Tsu-Kung ;

Chang, Chiung-Chih ;

Lu, Cheng-Hsien ;

Chang, Wen-Neng ;

Chen, Shang-Der ;

Tan, Teng-Yeow ;

Huang, Chi-Ren ;

Chan, Samuel H. H. .

EPILEPSIA, 2012, 53 (01) :120-128

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