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KMID : 1130620170130040371
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Journal of Clinical Neurology
2017 Volume.13 No. 4 p.371 ~ p.379
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Effects of Antiepileptic Drugs on the Carotid Artery Intima-Media Thickness in Epileptic Patients
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Lai Qi Lun
Shen Chun Hong
Zheng Yang
Zhang Yin Xi
Guo Yi
Ding Mei Ping
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Abstract
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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.
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KEYWORD
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antiepileptic drugs, atherosclerosis, intima-media thickness, meta-analysis
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