title: Antiepileptic medications and the risk for sudden cardiac death caused by an acute coronary event: a prospective case-control study.
abstract: BACKGROUND
  Epilepsy is associated with sudden death, but the reasons for this association are not well known. Objective We studied the role of antiepileptic drugs (AEDs) as a factor contributing to sudden cardiac death (SCD) in The Finnish Study of the Genotype and Phenotype Characteristics of Sudden Cardiac Death (FinGesture).
  
  
  RESULTS
  The FinGesture study compares the characteristics of victims of SCD caused by an autopsy-verified acute coronary event (cases) vs. survivors of an acute coronary event (ACS) (controls). The study population comprised 3737 cases (mean age 64 ± 12 y) and 3081 controls (mean age 66 ± 12 y). The use of AED was obtained from death certificates, autopsy/hospital records, national drug imbursement register, and interviews with the relatives. AEDs were more commonly used by the victims of SCD vs. controls (5.5% vs. 2.2%, adjusted odds ratio 2.7, 95% CI; 1.9-3.9; p < 0001). The use of AED for non-epilepsy indications was also more common in the cases than in controls (1.5% vs. 1.0%, p = 0.005).
  
  
  CONCLUSIONS
  A higher rate of AED was observed in victims of SCD than in a control group of ACS patients. Concomitant use of AED could be responsible for a small fraction of deaths due to acute coronary events. Key message Epilepsy has been associated with sudden cardiac death. The use of antiepileptic drugs seems to be associated with an increased risk of sudden cardiac death during a coronary event. Physicians should be aware of the risk related to antiepileptic drugs especially when used for other reasons than epilepsy.
authors.affiliation: a Medical Research Center Oulu, Institute of Clinical Medicine, University of Oulu , Oulu , Finland ;
authors.forename: Eeva
authors.initials: E
authors.lastname: Hookana
authors.affiliation: b Department of Neurology , University Hospital of Oulu , Oulu , Finland ;
authors.forename: Hanna
authors.initials: H
authors.lastname: Ansakorpi
authors.affiliation: c Department of Forensic Medicine , University of Oulu , Oulu , Finland.
authors.forename: Marja-Leena
authors.initials: ML
authors.lastname: Kortelainen
authors.affiliation: a Medical Research Center Oulu, Institute of Clinical Medicine, University of Oulu , Oulu , Finland ;
authors.forename: M Juhani
authors.initials: MJ
authors.lastname: Junttila
authors.affiliation: a Medical Research Center Oulu, Institute of Clinical Medicine, University of Oulu , Oulu , Finland ;
authors.forename: Kari S
authors.initials: KS
authors.lastname: Kaikkonen
authors.affiliation: a Medical Research Center Oulu, Institute of Clinical Medicine, University of Oulu , Oulu , Finland ;
authors.forename: Juha
authors.initials: J
authors.lastname: Perkiömäki
authors.affiliation: a Medical Research Center Oulu, Institute of Clinical Medicine, University of Oulu , Oulu , Finland ;
authors.forename: Heikki V
authors.initials: HV
authors.lastname: Huikuri
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality*; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D001344:Autopsy; D016022:Case-Control Studies; D016757:Death, Sudden, Cardiac / Q000453:epidemiology* / Q000209:etiology; D004827:Epilepsy / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000927:Anticonvulsants
keywords: Epilepsy; medical therapy; mortality