ArticleBMJ open2015
Antiepileptic drugs and the risk of ischaemic stroke and myocardial infarction: a population-based cohort study.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
16 citing papers in PubMed, 51 citations in OpenAlex.
- Comparative risk of major health events among individuals prescribed different antiseizure medications following ischemic stroke.Epilepsia · 2025Article
- Cardiovascular Effects of Antiseizure Medications for Epilepsy.CNS drugs · 2025Review
- Antiseizure medications and their differing effects on cardiovascular risk.Epilepsy & behavior reports · 2025Review
- Anti-epileptic Drugs Use and Increased Risk of Stroke: A Systematic Review.Annals of neurosciences · 2024Review
- Article
- The Effect of Levetiracetam Compared with Enzyme-Inducing Antiseizure Medications on Apixaban and Rivaroxaban Peak Plasma Concentrations.CNS drugs · 2024Observational
- Signal detection of adverse events associated with gabapentinoid use for chronic pain.Pharmacoepidemiology and drug safety · 2024Article
- The Epileptic Heart Syndrome: Epidemiology, pathophysiology and clinical detection.Epilepsy & behavior reports · 2024Article
- Interactions Between Direct Oral Anticoagulants (DOACs) and Antiseizure Medications: Potential Implications on DOAC Treatment.CNS drugs · 2023Article
- Assessment of asymmetric dimethylarginine and homocysteine in epileptic children receiving antiepileptic drugs.Pediatric research · 2022Article
- Risk of ischaemic stroke associated with antiepileptic drugs: a population-based case-control study in Catalonia.BMC neurology · 2021Article
- Ictal and Interictal Cardiac Manifestations in Epilepsy. A Review of Their Relation With an Altered Central Control of Autonomic Functions and With the Risk of SUDEP.Frontiers in neurology · 2021Review
- Antiepileptic drug use and mortality among community-dwelling persons with Alzheimer disease.Neurology · 2020Article
- Antiepileptic Drug Use and the Risk of Stroke Among Community-Dwelling People With Alzheimer Disease: A Matched Cohort Study.Journal of the American Heart Association · 2018Article
- Coronary heart disease risk in patients with schizophrenia: a Lebanese cross-sectional study.Journal of comorbidity · 2017Article
- The causes of new-onset epilepsy and seizures in the elderly.Neuropsychiatric disease and treatment · 2016Review
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesHepatic enzyme-inducing antiepileptic drugs (AEDs) increase serum lipid levels and other atherogenic markers via the induction of cytochrome P450 and may therefore increase the risk of vascular events. We sought to assess the risk of ischaemic stroke and myocardial infarction (MI) according to AED enzymatic properties.
designPopulation-based cohort study with nested case-control analysis.
setting650 general practices in the UK contributing to the Clinical Practice Research Datalink.
participantsA cohort of 252,407 incident AED users aged 18 or older between January 1990 and April 2013. For each case of ischaemic stroke or MI, up to 10 controls were randomly selected among the cohort members in the risk sets defined by the case and matched on age, sex, indication for AED, calendar time and duration of follow-up.
interventionsCurrent use of enzyme-inducing and enzyme-inhibiting AEDs compared with non-inducing AEDs. PRIMARY OUTCOME MEASURES: Incidence rate ratios (RRs) of ischaemic stroke and MI.
results5069 strokes and 3636 MIs were identified during follow-up. Inducing AEDs use was associated with a small increased risk of ischaemic stroke (RR=1.16, 95% CI 1.02 to 1.33) relative to non-inducing AEDs, most likely due to residual confounding. However, current use of inducing AEDs for ≥ 24 months was associated with a 46% increased risk of MI (RR=1.46, 95% CI 1.15 to 1.85) compared with the same duration of non-inducing AED, corresponding to a risk difference of 1.39/1000 (95% CI 0.33 to 2.45) persons per year. Current use of inhibiting AED was associated with a decreased risk of MI (RR=0.81, 95% CI 0.66 to 1.00).
conclusionsThe use of enzyme-inducing AEDs was not associated with an increased risk of ischaemic stroke; a small increase of MI with prolonged use was observed. In contrast, use of inhibiting AEDs was associated with a decreased risk of MI.
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