Risk Factors for Cardiovascular Events in Patients on Antidementia Medications.

IF 2.7 4区医学 Q2 CLINICAL NEUROLOGY American Journal of Alzheimers Disease and Other Dementias Pub Date : 2020-01-01 DOI:10.1177/1533317520922380

Meiqi He, James M Stevenson, Yuting Zhang, Inmaculada Hernandez

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Abstract

Objective: To identify characteristics associated with an increased risk of cardiovascular events in patients diagnosed with Alzheimer disease (AD) and treated with antidementia medications.

Methods: Demographics, diagnoses, and medication usage of 30 433 Medicare patients were analyzed using 2006 to 2013 claims data and a combined model of screening, ranking and stepwise logistic regressions to evaluate factors associated with composite outcomes of 6 cardiovascular events.

Results: Incidence rate of at least 1 cardiovascular event was 25.1%. Fifty-five factors were identified from the 10 381 candidate variables by the combined model with a c-statistic of 67% and an accuracy of 75%. Factors associated with increased risk of cardiovascular events include history of heart rhythm disorders, alteration of consciousness (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.14-1.36), and usage of β-blockers (OR: 1.19; 95% CI: 1.13-1.27).

Conclusions: Clinicians should consider the increased risk of cardiovascular events in patients with AD with heart rhythm disorders and on β-blockers.

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服用抗痴呆药物的患者发生心血管事件的风险因素。

目的确定被诊断为阿尔茨海默病（AD）并接受抗痴呆药物治疗的患者中与心血管事件风险增加相关的特征：利用 2006 年至 2013 年的理赔数据分析了 30 433 名医疗保险患者的人口统计学特征、诊断和用药情况，并采用筛选、排序和逐步逻辑回归相结合的模型评估与 6 次心血管事件综合结果相关的因素：至少1例心血管事件的发生率为25.1%。综合模型从 10 381 个候选变量中识别出 55 个因素，c 统计量为 67%，准确率为 75%。与心血管事件风险增加相关的因素包括心律紊乱病史、意识改变（比值比 [OR]：1.25；95% 置信区间 [CI]：1.14-1.36）和使用β-受体阻滞剂（OR：1.19；95% CI：1.13-1.27）：临床医生应考虑到患有心律失常和服用β-受体阻滞剂的AD患者发生心血管事件的风险增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Alzheimers Disease and Other Dementias GERIATRICS & GERONTOLOGY-CLINICAL NEUROLOGY

CiteScore

5.40

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： American Journal of Alzheimer''s Disease and other Dementias® (AJADD) is for professionals on the frontlines of Alzheimer''s care, dementia, and clinical depression--especially physicians, nurses, psychiatrists, administrators, and other healthcare specialists who manage patients with dementias and their families. This journal is a member of the Committee on Publication Ethics (COPE).