학술논문
Safety and efficacy of concomitant treatment with non-vitamin K antagonist oral anticoagulants and antiseizure medications: A propensity score matching cohort study.
Document Type
Academic Journal
Author
Giustozzi M; Stroke Unit and Division of Cardiovascular Medicine, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Calvello C; Neurology Clinic, Department of Medicine and Surgery, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Eusebi P; Neurology Clinic, Department of Medicine and Surgery, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Paolini Paoletti F; Neurology Clinic, Department of Medicine and Surgery, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Silvestrelli G; Neurology Clinic and Stroke Unit, ASST, Mantova, Italy.; Mazzetti M; Internal Medicine, Careggi Hospital, University of Florence, Florence, Italy.; Silla M; Neurology Clinic, Department of Medicine and Surgery, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Bellotti A; Neurology Clinic, Department of Medicine and Surgery, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Vedovati MC; Stroke Unit and Division of Cardiovascular Medicine, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Becattini C; Stroke Unit and Division of Cardiovascular Medicine, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Romoli M; Neurology Clinic and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Cesena, Italy.; Parnetti L; Neurology Clinic, Department of Medicine and Surgery, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Paciaroni M; Stroke Unit and Division of Cardiovascular Medicine, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.; Costa C; Neurology Clinic, Department of Medicine and Surgery, Santa Maria Della Misericordia Hospital, University of Perugia, Perugia, Italy.
Source
Publisher: Blackwell Science Country of Publication: United States NLM ID: 2983306R Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1167 (Electronic) Linking ISSN: 00139580 NLM ISO Abbreviation: Epilepsia Subsets: MEDLINE
Subject
Language
English
Abstract
Research on cerebrovascular events in atrial fibrillation (AF) patients taking non-vitamin K antagonist oral anticoagulants (NOACs) with antiseizure medications (ASMs) is limited, highlighting a significant gap in literature. We assessed thrombotic and hemorrhagic risks in patients on NOACs and ASMs versus those on NOACs or ASMs alone. We analyzed a retrospective cohort from five centers, including AF and epilepsy patients on both medications (n = 188), AF patients on NOACs (n = 298), and epilepsy patients on ASMs (n = 50), with a 3-year follow-up. Propensity score matching adjusted for cardiovascular risk differences. The primary outcomes were ischemic stroke, transient ischemic attack, and major bleeding. Results showed the ASM+NOAC group had a higher risk of primary outcomes compared to the NOAC-only group (5.68% vs. 1.18%, hazard ratio = 5.72, 95% confidence interval = 2.22-14.73), with no events in the ASM-only group. This suggests an increased risk for patients on combined NOAC and ASM therapy, underlining the need for careful drug interaction consideration.
(© 2024 International League Against Epilepsy.)
(© 2024 International League Against Epilepsy.)