Epilepsy-Heart Syndrome: CVD events increase after epileptic seizures on a long and short-term basis
Epilepsy is associated with increased risk of cardiovascular events (CVEs) such as stroke, acute coronary syndrome (ACS) and sudden cardiac death.Also the pathophysiological mechanisms underlying this are complex and multifaceted.
Cardiovascular events increase after an epileptic seizure on a long and short-term basis suggests a new study published in the Current Problems in Cardiology
The risks of cardiovascular events (CVEs) in people with epilepsy(PWE) are not well understood.
A study was done to establish the short- and long-term burden of CVEs in PWE.
Electronic health records from a global federated health research network (TriNetX) were used to establish a cohort of PWE. Primary outcomes were: i) the proportion of people experiencing a composite outcome of cardiac arrest, acute heart failure (HF), acute coronary syndrome(ACS), atrial fibrillation(AF), severe ventricular arrhythmia or all-cause death within 30 days of seizure; and ii) the 5-year risk for a composite outcome of ischemic heart diseases, stroke, hospitalization, or all-cause death in the PWE experiencing early CVEs. Cox-regression analyses with propensity score matching was used to produce hazard ratios (HRs) and 95% confidence intervals (CI).
Results
In 271,172 PWE (mean age 50±20 years; 52% females), the 30-day risk of CVEs following seizure was: 8.7% for the composite outcome, 0.9% for cardiac arrest, 0.8% for HF, 1.2% for ACS, 4.1% for AF, 0.7% for severe ventricular arrhythmias, and 1.6% for all-cause death. For the 15,120 PWE experiencing CVEs within 30 days of seizure, the 5-year adjusted risks for all composite outcomes measured were significantly increased (overall HR: 2.44, 95%CI 2.37–2.51), ischemic heart diseases HR 3.23 (95%CI 3.10–3.36), stroke HR 1.56 (95%CI 1.48–1.64), hospitalization HR 2.03 (95%CI 1.97–2.10), and all-cause death HR 2.75 (95%CI 2.61–2.89).
The large proportions of PWE with active disease that experience CVEs and the poor long-term outcome associated suggest the existence of an ‘epilepsy-heart syndrome’.
Reference:
Azmil H. Abdul-Rahim, Gregory Y.H. Lip. Epilepsy-Heart Syndrome: Incidence and Clinical Outcomes of Cardiac Complications in Patients with Epilepsy. Current Problems in Cardiology, 2023, 101868, ISSN 0146-2806. https://doi.org/10.1016/j.cpcardiol.2023.101868.
(https://www.sciencedirect.com/science/article/pii/S0146280623002852)
