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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Epilepsy
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1378682
This article is part of the Research Topic Epilepsy Mortality: Leading Causes of Death, Co-morbidities, Cardiovascular Risk and Prevention, Volume II View all 9 articles

Temporal Trends, In-Hospital Outcomes, and Risk Factors of Acute Myocardial Infarction among Patients with Epilepsy in The United States: A Retrospective National Database Analysis from 2008 to 2017

Provisionally accepted
Zhemin Pan Zhemin Pan 1Xi Xu Xi Xu 2*Shengyong Wu Shengyong Wu 3*Xi Chen Xi Chen 4Xiao Luo Xiao Luo 3*Chenxin Chen Chenxin Chen 3Peimin Yu Peimin Yu 5*Yingyi Qin Yingyi Qin 3Jia He Jia He 1,3*
  • 1 Medical School, Tongji University, Shanghai, China
  • 2 Department of Urinary Surgery, Changhai Hospital, Shanghai, China
  • 3 Department of Health Statistics, Second Military Medical University, Shanghai, China
  • 4 School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Jiangsu Province, China
  • 5 Department of Neurology, Huashan Hospital, Fudan University, Shanghai, Shanghai Municipality, China

The final, formatted version of the article will be published soon.

    Background: The relationship between epilepsy and risk of acute myocardial infarction (AMI) is not fully understood. Evidence from the Stockholm Heart Study indicates that the risk of AMI is increased in people with epilepsy (Janszky et al. 2009). This study aims to analyze the temporal trends in prevalence, adverse clinical outcomes, and risk factors of AMI in patients with epilepsy (PWE). Methods: Patients aged 18 years or older, diagnosed with epilepsy with or without AMI and hospitalized from January 1, 2008, to December 31, 2017, were identified from the National Inpatient Sample (NIS) database. The Cochran–Armitage trend test and logistic regressions were conducted using SAS 9.4. Odds ratios (ORs) were generated for multiple variables. Results: A total of 8,456,098 inpatients were eligible for our analysis, including 181,826 comorbid with AMI (2.15%). The prevalence of AMI diagnosis in PWE significantly increased from 1,911.7 per 100,000 hospitalizations in 2008 to 2,529.5 per 100,000 hospitalizations in 2017 (Ptrend <0.001). Inpatient mortality was significantly higher in epilepsy patients with AMI compared to those without AMI (OR=4.61, 95% CI: 4.54 to 4.69). Factors significantly associated with AMI in PWE included age (≥75 years old vs 18~44 years old, OR=3.54, 95% CI: 3.45 to 3.62), atherosclerosis (OR=4.44, 95% CI: 4.40 to 4.49), conduction disorders (OR=2.21, 95% CI: 2.17 to 2.26), cardiomyopathy (OR=2.11, 95% CI: 2.08 to 2.15) , coagulopathy (OR=1.52, 95% CI: 1.49 to 1.54), dyslipidemia (OR=1.26, 95% CI: 1.24 to 1.27), peptic ulcer disease (OR=1.23, 95% CI: 1.13 to 1.33), chronic kidney disease (OR=1.23, 95% CI: 1.22 to 1.25), smoking (OR=1.20, 95% CI: 1.18 to 1.21), and weight loss (OR=1.20, 95% CI: 1.18 to 1.22). Conclusion: The prevalence of AMI in PWE increased during the decade. Mortality rates were high among this population, highlighting the need for comprehensive attention to prophylaxis for risk factors and early diagnosis of AMI in PWE by physicians.

    Keywords: acute myocardial infarction, Atherosclerotic cardiovascular disease, clinical outcomes, Dyslipidemia, Epilepsy, Prevalence, Risk factors

    Received: 19 Feb 2024; Accepted: 25 Jul 2024.

    Copyright: © 2024 Pan, Xu, Wu, Chen, Luo, Chen, Yu, Qin and He. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xi Xu, Department of Urinary Surgery, Changhai Hospital, Shanghai, China
    Shengyong Wu, Department of Health Statistics, Second Military Medical University, Shanghai, China
    Xiao Luo, Department of Health Statistics, Second Military Medical University, Shanghai, China
    Peimin Yu, Department of Neurology, Huashan Hospital, Fudan University, Shanghai, Shanghai Municipality, China
    Jia He, Medical School, Tongji University, Shanghai, China

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