Transient Anticholinergic Exposure Tied to Cardiac Risk

Anticholinergic drugs have been associated with cardiovascular mortality. The exact mechanism remains unclear, but pro-arrhythmic and pro-ischemic effects are suspected. To investigate whether transient exposure to anticholinergics increases a patient’s risk for cardiac arrest, researchers used a Taiwanese health insurance database to conduct a case-crossover study among 174,000 patients 40 or older with out-of-hospital cardiac arrest (OHCA); the mean age was 72.

Using prescription drug records, the researchers calculated an anticholinergic burden score for each patient (“none” = 0, “moderate” = 1–2, and “high” = 3). They examined each patient’s anticholinergic burden 30 days preceding the OHCA and during a randomly selected 30-day re…