Abstract 16650: Association of Selected Anti-Psychotic Agents With Major Adverse Cardiovascular Events in Elderly Individuals: A Danish Nationwide Cohort Study
Introduction: Concerns have been raised about the safety of treatment with antipsychotic agents (APS) in elderly people with dementia, but this area is still insufficiently investigated. We studied the risks of major adverse cardiovascular events (MACE; non-fatal myocardial infarction, non-fatal stroke or cardiovascular death) associated with use of different APS in elderly using nationwide Danish data.
Methods: All individuals in Denmark aged 70 years or older between 1997 and 2009 who had not used APS prior to study baseline were included. Exposure to APS was assessed through claimed prescriptions from pharmacies. Adjusted relative risks (RR) associated with exposure to APS were calculated by time-dependent Poisson regression models.
Results: We included 1,235,869 individuals of which 100,140 (8,1%) used APS at some point. For all agents, we found a highly increased RR of MACE during the first month after initiation, Figure. Long-term use (i.e.> 1 year) was however still associated with approximately 2-fold increase in RR for the majority of agents. The majority of agents further demonstrated a dose-dependent increase in RR and higher RR associated with long-term use among individuals without prevalent cardiovascular disease or dementia.
Conclusions: Use of APS was associated with increased risks of MACE among elderly individuals, in particular during the first month after treatment initiation. The risks were not lower among patients without dementia or cardiovascular disease, which may warrant consideration in future guidelines.
- © 2013 by American Heart Association, Inc.