Enzyme-Inducing Anticonvulsants: Long-Term Cardiovascular Risk

Enzyme-inducing antiseizure medications increase the risk for new cardiovascular disease over the long term.

The treatment of persons with epilepsy (PWE) is founded on antiseizure medications (ASMs). The chronic nature of epilepsy entails long-term use of ASMs, and the emergence of iatrogenic morbidities on long timescales is an important consideration. Liver enzyme–inducing ASMs (eiASMs) are a particular concern due to their widespread metabolic and pharmacodynamic effects. In this retrospective cohort study, researchers tracked cardiovascular outcomes in 31,479 PWE older than 18 years for a median of 9 years.

In propensity-matched survival analyses and weighted cumulative exposure models, incidence of cardiovascular disease was significantly higher in PWE treated with eiASM (hazard ratio, 1.21) than those treated with non-eiASM. The difference wa…

Reviewing Authors

Maria Bruzzone, MD, MSCR

Giridhar Kalamangalam, MD, DPhil

Enzyme-Inducing Anticonvulsants: Long-Term Cardiovascular Risk

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Reviewing Authors