RT Journal Article
T1 Acetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non-hypertensive Alzheimer's patients
A1 Al-Hamed, Faez Saleh
A1 Kouniaris, Stamatis
A1 Tamimi, Iskandar
A1 Lordkipanidze, Marie
A1 Madathil, Sreenath Arekunnath
A1 Kezouh, Abbas
A1 Karp, Igor
A1 Nicolau, Belinda
A1 Tamimi, Faleh
K1 acetylcholinesterase inhibitors
K1 aging
K1 Alzheimer's disease
K1 bleeding
K1 cardiovascular disease
K1 stroke
K1 Cholinesterase-inhibitors
K1 Myocardial-infarction
K1 Blood-pressure
K1 Disease
K1 Dementia
K1 Validity
K1 Stroke
K1 Adults
AB 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.
PB Wiley
YR 2021
FD 2021-01-01
LK https://hdl.handle.net/10668/24350
UL https://hdl.handle.net/10668/24350
LA en
DS RISalud
RD Apr 6, 2025