| Title: | Long-term risk of major adverse cardiovascular events in patients with epilepsy: Roles of childhood onset and antiseizure medications |
| Journal: | Epilepsy Research |
| Published: | 7 Jun 2026 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/42263508/ |
| DOI: | https://doi.org/10.1016/j.eplepsyres.2026.107846 |
Publication 20841
WARNING: the interactive features of this website use CSS3, which your browser does not support. To use the full features of this website, please update your browser.
Abstract
PURPOSE: Evidence regarding long-term major adverse cardiovascular events (MACEs) risk in patients with epilepsy (PWE) remains limited. This study investigates the longitudinal epilepsy-MACE association, with specific focus on the roles of childhood-onset epilepsy and antiseizure medications (ASMs) exposure.</p>
METHODS: This population-based cohort study included 459,534 UK Biobank participants recruited from 2006 to 2010. MACE risk in epilepsy was evaluated using Kaplan-Meier survival curves and multivariable Cox proportional hazards models; stratified analyses by age at onset and ASM exposure were performed, with sensitivity analyses to verify robustness.</p>
RESULTS: Among 459,534 individuals, 4401 (0.96%) had epilepsy and 455,133 (99.04%) did not. Compared to those without epilepsy, PWE were associated with significantly higher long-term risks of MACE: HR 1.43 [95% CI, 1.34-1.53], including coronary heart disease (CHD) (HR 1.32 [95% CI, 1.20-1.44]), atrial fibrillation (AF) (HR 1.44 [95% CI, 1.30-1.60]), heart failure (HF) (HR 1.44 [95% CI, 1.24-1.67]), stroke (HR 2.03 [95% CI, 1.77-2.33]), and transient ischemic attack (TIA) (HR 1.55 [95% CI, 1.23-1.95]). Sensitivity analyses corroborated these findings. Notably, the risk of MACE associated with childhood-onset epilepsy was not significantly higher than that with adult-onset epilepsy. Furthermore, the use of ASMs - including both sodium channel blockers (SCBs) and enzyme-inducing ASMs (EIASMs) - did not show an increased risk of MACE in PWE compared to those not taking ASMs.</p>
CONCLUSIONS: Epilepsy is associated with elevated long-term MACE risk.Crucially, childhood-onset epilepsy confers no higher cardiovascular risk than adult-onset epilepsy, and ASMs (including SCBs and EIASMs) collectively do not elevate MACE risk in PWE These findings highlight routine cardiovascular monitoring in PWE.</p>
7 Authors
- Guifen Zhang
- Junjie Lin
- Xiaolin Xu
- Wenyuan Li
- Baohui Wang
- Xiaoyu Li
- Yi Guo
1 Application
| Application ID | Title |
|---|---|
| 91486 | Social, lifestyle, and biological risk factors of age-related diseases and mortality |
Enabling scientific discoveries that improve human health