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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 st...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8377777/ https://www.ncbi.nlm.nih.gov/pubmed/34458554 http://dx.doi.org/10.1002/trc2.12184 |
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author | Al‐Hamed, Faez Saleh Kouniaris, Stamatis Tamimi, Iskandar Lordkipanidzé, Marie Madathil, Sreenath Arekunnath Kezouh, Abbas Karp, Igor Nicolau, Belinda Tamimi, Faleh |
author_facet | Al‐Hamed, Faez Saleh Kouniaris, Stamatis Tamimi, Iskandar Lordkipanidzé, Marie Madathil, Sreenath Arekunnath Kezouh, Abbas Karp, Igor Nicolau, Belinda Tamimi, Faleh |
author_sort | Al‐Hamed, Faez Saleh |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8377777 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83777772021-08-27 Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non‐hypertensive Alzheimer's patients Al‐Hamed, Faez Saleh Kouniaris, Stamatis Tamimi, Iskandar Lordkipanidzé, Marie Madathil, Sreenath Arekunnath Kezouh, Abbas Karp, Igor Nicolau, Belinda Tamimi, Faleh Alzheimers Dement (N Y) Featured Articles 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. John Wiley and Sons Inc. 2021-08-20 /pmc/articles/PMC8377777/ /pubmed/34458554 http://dx.doi.org/10.1002/trc2.12184 Text en © 2021 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals, Inc. on behalf of Alzheimer's Association. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Featured Articles Al‐Hamed, Faez Saleh Kouniaris, Stamatis Tamimi, Iskandar Lordkipanidzé, Marie Madathil, Sreenath Arekunnath Kezouh, Abbas Karp, Igor Nicolau, Belinda Tamimi, Faleh Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non‐hypertensive Alzheimer's patients |
title | Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non‐hypertensive Alzheimer's patients |
title_full | Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non‐hypertensive Alzheimer's patients |
title_fullStr | Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non‐hypertensive Alzheimer's patients |
title_full_unstemmed | Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non‐hypertensive Alzheimer's patients |
title_short | Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non‐hypertensive Alzheimer's patients |
title_sort | acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non‐hypertensive alzheimer's patients |
topic | Featured Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8377777/ https://www.ncbi.nlm.nih.gov/pubmed/34458554 http://dx.doi.org/10.1002/trc2.12184 |
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