Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non-hypertensive Alzheimer’s patients

Article
Version publiée / Version of Record

Fichiers

Al-Hamed 2021.pdf (546.34 KB)

Date de publication

2021-08-20

Autrices et auteurs

Identifiant ORCID de l’auteur

Contributrices et contributeurs

Direction de recherche

Publié dans

Alzheimer's and dementia

Date de la Conférence

Lieu de la Conférence

Éditeur

Cycle d'études

Programme

Affiliation

Université de Montréal. Faculté de pharmacie

Mots-clés

  • Acetylcholinesterase inhibitors
  • Aging
  • Alzheimer’s disease
  • Bleeding
  • Cardiovascular disease
  • Stroke

Organisme subventionnaire

Résumé

Résumé

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.

Table des matières

Notes

Notes

URI

http://hdl.handle.net/1866/25739

DOI

10.1002/trc2.12184

Autre version linguistique

Ensemble de données lié

Licence

Ce document est mis à disposition selon les termes de la Licence Creative Commons Attribution - Pas d’utilisation commerciale 4.0 International. / This work is licensed under a Creative Commons Attribution - NonCommercial 4.0 International License.

Collections

Faculté de pharmacie – Travaux et publications

Approbation

Évaluation

Complété par

Référencé par

Ce document diffusé sur Papyrus est la propriété exclusive des titulaires des droits d'auteur et est protégé par la Loi sur le droit d'auteur (L.R.C. (1985), ch. C-42). Sauf si le document est diffusé sous une licence Creative Commons, il ne peut être utilisé que dans le cadre d'une utilisation équitable et non commerciale comme le prévoit la Loi (i.e. à des fins d'étude privée ou de recherche, de critique ou de compte-rendu). Pour toute autre utilisation, une autorisation écrite des titulaires des droits d'auteur sera nécessaire.