Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non-hypertensive Alzheimer’s patients.
Introduction: Acetylcholinesterase inhibitors (AChEIs) are commonly used to treat mild to moderate cases of Alzheimer disease (AD). To the best of our knowledge, there has been no study estimating the risk of bleeding and cardiovascular events in patients with non-hypertensive AD. Therefore, this study aimed to estimate the association between AChEIs and the risk of bleeding and cardiovascular ischemic events in patients with non-hypertensive AD.
Methods: A nested case-control study was conducted to estimate the risk of bleeding and ischemic events (angina, myocardial infarction [MI], and stroke) in patients with AD. This study was conducted using the UK Clinical Practice Research Datalink and Hospital Episode Statistics (HES) databases. The study cohort consisted of AD patients >/=65 years of age. The case groups included all AD subjects in the database who had a bleeding or ischemic event during the cohort follow-up. Four controls were selected for each case. Patients were classified as current users or past users based on a 60-day threshold of consuming the drug. Simple and multivariable conditional logistic regression analyses were used to calculate the adjusted odds ratio for bleeding events and cardiovascular events.
Results: We identified 507 cases and selected 2028 controls for the bleeding event cohort and 555 cases and 2220 controls for the ischemic event cohort. The adjusted odds ratio (OR) (95% confidence interval [CI]) for the association of AChEI use was 0.93 (0.75 to 1.16) for bleeding events, 2.58 (1.01 to 6.59) for angina, and 1.89 (1.07 to 3.33) for MI. Past users of AChEIs were also at increased risk of stroke (1.51 [1.00 to 2.27]).
Discussion: This is the first study assessing the risk of bleeding and cardiovascular events in patients with non-hypertensive AD. Our findings could be of great interest for clinicians and researchers working on AD.
|投稿者||Al-Hamed, Faez Saleh; Kouniaris, Stamatis; Tamimi, Iskandar; Lordkipanidze, Marie; Madathil, Sreenath Arekunnath; Kezouh, Abbas; Karp, Igor; Nicolau, Belinda; Tamimi, Faleh|
|ジャーナル名||Alzheimer's & dementia (New York, N. Y.)|
|組織名||Faculty of Dentistry McGill University 2001 McGill College Avenue Montreal Quebec;H3A 1G1 Canada.;Orthopedic Surgery Department Hospital Regional Universitario de Malaga Malaga;Spain.;Faculte de pharmacie Universite de Montreal Montreal Quebec Canada.;Research Center Montreal Heart Institute Montreal Quebec Canada.;Department of Epidemiology and Biostatistics Davis Institute Montreal Quebec;Canada.;Department of Epidemiology and Biostatistics Schulich School of Medicine and;Dentistry Western University London Ontario Canada.;Departement de Medecine Sociale et Preventive Universite de Montreal Montreal;Quebec Canada.;College of Dental Medicine Qatar University Doha Qatar.|