Zeinab Peymani, Abbas Tafakhori, Saeed Farzanehfar, Farnoosh Larti, Ali Hosseini, Mehrshad Abbasi
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SPECT with cardiac gating was done by a dual-head gamma camera and processed and quantified. Scans with at least one definite reversible hypo-perfusion segment were considered abnormal.</p><p><strong>Results: </strong>Seventeen patients received carbamazepine monotherapy and 15 valproates. Age and duration of AED use were similar between the groups. Two scans were abnormal (6.3%) both in valproate group (13.3%). Duration of AED use was higher in patients with abnormal scans. In patients receiving monotherapy >2 years, the frequency of abnormal MPI was similar between groups (P-value=0.12). In patients receiving monotherapy > 5 years, prevalence of abnormal MPI was higher in the valproate group (28.6% vs. 0.0%; P-value=0.042). Considering valproate subgroup, ischemic patients had higher duration of AED use, comparing with the normal patients (17.0±4.2 vs. 6.4±4.8, P-value=0.014).</p><p><strong>Conclusion: </strong>MPIs were abnormal in patients receiving valproate after 5 years compared to patients receiving carbamazepine. Long-term valproate use may increase the risk of CAD.</p>","PeriodicalId":8503,"journal":{"name":"Asia Oceania Journal of Nuclear Medicine and Biology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10261687/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparison of myocardial perfusion between the users of two antiepileptic medications: valproate vs. carbamazepine.\",\"authors\":\"Zeinab Peymani, Abbas Tafakhori, Saeed Farzanehfar, Farnoosh Larti, Ali Hosseini, Mehrshad Abbasi\",\"doi\":\"10.22038/AOJNMB.2023.67084.1465\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The prevalence of coronary artery disease (CAD) is high in patients with epilepsy using antiepileptic drugs (AED). Epilepsy, AED, or the type and duration of AED use , may contribute to higher CAD risk.In this study, myocardial perfusion imaging (MPI) was compared between patients using carbamazepine and valproate.</p><p><strong>Method: </strong>Out of 73 patients receiving carbamazepine or valproate monotherapy for more than 2 years, visited at a tertiary referral clinic, 32 patients participated in a 2-day stress and rest phases MPI. For each phase, 15-25 mCi 99mTc-MIBI was injected, at peak exercise or by pharmacologic stimulation for the stress phase. SPECT with cardiac gating was done by a dual-head gamma camera and processed and quantified. Scans with at least one definite reversible hypo-perfusion segment were considered abnormal.</p><p><strong>Results: </strong>Seventeen patients received carbamazepine monotherapy and 15 valproates. Age and duration of AED use were similar between the groups. Two scans were abnormal (6.3%) both in valproate group (13.3%). Duration of AED use was higher in patients with abnormal scans. In patients receiving monotherapy >2 years, the frequency of abnormal MPI was similar between groups (P-value=0.12). In patients receiving monotherapy > 5 years, prevalence of abnormal MPI was higher in the valproate group (28.6% vs. 0.0%; P-value=0.042). Considering valproate subgroup, ischemic patients had higher duration of AED use, comparing with the normal patients (17.0±4.2 vs. 6.4±4.8, P-value=0.014).</p><p><strong>Conclusion: </strong>MPIs were abnormal in patients receiving valproate after 5 years compared to patients receiving carbamazepine. Long-term valproate use may increase the risk of CAD.</p>\",\"PeriodicalId\":8503,\"journal\":{\"name\":\"Asia Oceania Journal of Nuclear Medicine and Biology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10261687/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Asia Oceania Journal of Nuclear Medicine and Biology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.22038/AOJNMB.2023.67084.1465\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Asia Oceania Journal of Nuclear Medicine and Biology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.22038/AOJNMB.2023.67084.1465","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的:使用抗癫痫药物(AED)的癫痫患者冠状动脉疾病(CAD)患病率高。癫痫、AED或AED使用的类型和持续时间可能会增加冠心病的风险。在本研究中,比较了卡马西平和丙戊酸患者的心肌灌注成像(MPI)。方法:73例接受卡马西平或丙戊酸单药治疗超过2年的患者,在三级转诊诊所就诊,32例患者参加了为期2天的应激和休息期MPI。在每个阶段,在运动高峰期或应激期通过药物刺激注射15-25 mCi 99mTc-MIBI。心门控SPECT采用双头伽马照相机进行处理和量化。扫描至少有一个明确的可逆性低灌注段被认为是异常的。结果:卡马西平单药治疗17例,丙戊酸盐治疗15例。两组患者使用AED的年龄和持续时间相似。2次扫描异常(6.3%),丙戊酸组均异常(13.3%)。扫描异常的患者使用AED的时间更长。在接受单药治疗>2年的患者中,两组间MPI异常频率相似(p值=0.12)。在接受单药治疗> 5年的患者中,丙戊酸组MPI异常患病率更高(28.6% vs 0.0%;假定值= 0.042)。在丙戊酸亚组中,缺血性患者AED使用时间高于正常患者(17.0±4.2∶6.4±4.8,p值=0.014)。结论:与卡马西平组相比,丙戊酸组5年后MPIs异常。长期使用丙戊酸可能增加冠心病的风险。
Comparison of myocardial perfusion between the users of two antiepileptic medications: valproate vs. carbamazepine.
Objectives: The prevalence of coronary artery disease (CAD) is high in patients with epilepsy using antiepileptic drugs (AED). Epilepsy, AED, or the type and duration of AED use , may contribute to higher CAD risk.In this study, myocardial perfusion imaging (MPI) was compared between patients using carbamazepine and valproate.
Method: Out of 73 patients receiving carbamazepine or valproate monotherapy for more than 2 years, visited at a tertiary referral clinic, 32 patients participated in a 2-day stress and rest phases MPI. For each phase, 15-25 mCi 99mTc-MIBI was injected, at peak exercise or by pharmacologic stimulation for the stress phase. SPECT with cardiac gating was done by a dual-head gamma camera and processed and quantified. Scans with at least one definite reversible hypo-perfusion segment were considered abnormal.
Results: Seventeen patients received carbamazepine monotherapy and 15 valproates. Age and duration of AED use were similar between the groups. Two scans were abnormal (6.3%) both in valproate group (13.3%). Duration of AED use was higher in patients with abnormal scans. In patients receiving monotherapy >2 years, the frequency of abnormal MPI was similar between groups (P-value=0.12). In patients receiving monotherapy > 5 years, prevalence of abnormal MPI was higher in the valproate group (28.6% vs. 0.0%; P-value=0.042). Considering valproate subgroup, ischemic patients had higher duration of AED use, comparing with the normal patients (17.0±4.2 vs. 6.4±4.8, P-value=0.014).
Conclusion: MPIs were abnormal in patients receiving valproate after 5 years compared to patients receiving carbamazepine. Long-term valproate use may increase the risk of CAD.