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AuthorAl-Hamed, Faez Saleh
AuthorKouniaris, Stamatis
AuthorTamimi, Iskandar
AuthorLordkipanidzé, Marie
AuthorMadathil, Sreenath Arekunnath
AuthorKezouh, Abbas
AuthorKarp, Igor
AuthorNicolau, Belinda
AuthorTamimi, Faleh
Available date2022-05-31T19:01:21Z
Publication Date2021
Publication NameAlzheimer's and Dementia: Translational Research and Clinical Interventions
ResourceScopus
Identifierhttp://dx.doi.org/10.1002/trc2.12184
URIhttp://hdl.handle.net/10576/31823
AbstractIntroduction 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.
Languageen
PublisherJohn Wiley and Sons Inc
Subjectanticoagulant agent
cholinesterase inhibitor
donepezil
galantamine
hydroxymethylglutaryl coenzyme A reductase inhibitor
rivastigmine
acute ischemic stroke
aged
Alzheimer disease
angina pectoris
Article
bleeding
brain hemorrhage
case control study
case study
cohort analysis
controlled study
disease association
female
follow up
heart infarction
hospital based case control study
human
major clinical study
male
medication compliance
patient compliance
population based case control study
prescription
risk reduction
very elderly
TitleAcetylcholinesterase inhibitors and risk of bleeding and acute ischemic events in non-hypertensive Alzheimer's patients
TypeArticle
Issue Number1
Volume Number7


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