Effects of Antiepileptic Drugs on the Carotid Artery Intima-Media Thickness in Epileptic Patients.
10.3988/jcn.2017.13.4.371
- Author:
Qilun LAI
1
;
Chunhong SHEN
;
Yang ZHENG
;
Yinxi ZHANG
;
Yi GUO
;
Meiping DING
Author Information
1. Department of Neurology, Zhejiang Hospital, Hangzhou, China.
- Publication Type:Meta-Analysis ; Original Article
- Keywords:
antiepileptic drugs;
atherosclerosis;
intima-media thickness;
meta-analysis
- MeSH:
Adult;
Anticonvulsants*;
Atherosclerosis;
Carbamazepine;
Carotid Arteries*;
Child;
Epilepsy;
Humans;
Phenytoin;
Valproic Acid
- From:Journal of Clinical Neurology
2017;13(4):371-379
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND PURPOSE: It has been reported that taking antiepileptic drugs (AEDs) may increase the risk of atherosclerosis. We performed a meta-analysis to evaluate the carotid artery intima-media thickness (CA-IMT) as a surrogate factor for atherosclerosis in epileptic patients. METHODS: We searched NCBI (PubMed), ISI Web of Knowledge, EMBASE, and the Cochrane Library databases for studies of the association between AEDs and CA-IMT in epileptic patients. A random-effects meta-analysis was used to pool results across studies. RESULTS: Fifteen studies involving 1,775 epileptic patients were included in the analysis. The overall CA-IMT was significantly larger among users of AEDs [mean difference (MD)=0.09 mm, 95% confidence interval (CI)=0.06–0.12 mm). When stratified by age, the MD was similar in adult patients (MD=0.09 mm, 95% CI=0.06–0.13 mm), but no significant difference was observed in children (MD=0.03 mm, 95% CI=0.00–0.07 mm). Regarding specific AEDs, monotherapy with carbamazepine (CBZ) or valproic acid (VPA) was associated with a larger CA-IMT, while phenytoin monotherapy was not and the result for lamotrigine was inconclusive. CONCLUSIONS: This study suggests that using AEDs is associated with the CA-IMT in patients with epilepsy, particularly for adult patients. In particular, CBZ and VPA may be related to a significant increase in CA-IMT.
