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Relationship between antiepileptic drugs and biological markers affecting long-term cardiovascular function in
Laura S Cheng1, Asuri N Prasad, Michael J Rieder
1Department of Physiology and Pharmacology, University of Western Ontario, London, Ontario, Canada.
Insights
Long-term use of antiepileptic drugs (AEDs) in children with epilepsy may elevate homocysteine and lipoprotein levels, increasing cardiovascular disease risk. Further research is needed to understand these risks.
Area of Science:
- Neurology
- Pharmacology
- Cardiovascular Science
Background:
- Epilepsy is a common pediatric neurological disorder.
- Children with epilepsy often undergo long-term treatment with antiepileptic drugs (AEDs).
- Chronic AED exposure can alter plasma homocysteine and serum lipoprotein levels.
Purpose of the Study:
- To review the cardiovascular effects of anticonvulsant therapy in childhood epilepsy.
- To examine the role of homocysteine and lipoprotein concentrations in this context.
Main Methods:
- Conducted a literature search of PubMed and MEDLINE databases (1966-May 2009).
- Utilized keywords: antiepileptic drugs, epilepsy, homocysteine, cardiovascular events, children.
Main Results:
- Specific AEDs (carbamazepine, phenobarbital, phenytoin, valproic acid) can elevate homocysteine and lipoprotein levels.
- Genetic factors, such as 5-methylenetetrahydrofolate reductase polymorphism, may contribute to these elevations.
Conclusions:
- Elevated homocysteine and lipoprotein are linked to long-term cardiovascular disease risk in children on AEDs.
- Concerns exist regarding the chronic implications of AED use and cardiovascular risk in pediatric populations.
- Further research is necessary to clarify the relationships between specific AEDs, biochemical markers, genotype, and long-term outcomes.
Background:
Epilepsy is a neurological disorder, relatively common in the paediatric population. These children are often treated with antiepileptic drugs (AEDs) for several years. The consequence of such long-term exposure may lead to variations in plasma homocysteine and serum lipoprotein concentrations.
Objective(S):
To review the cardiovascular effects of anticonvulsant therapy and their use in childhood epilepsy with special reference to homocysteine and lipoprotein.
Methods:
A literature search was conducted on PubMed (1966-May 2009) and MEDLINE (1966-May 2009). Key terms included antiepileptic drugs, epilepsy, homocysteine, cardiovascular events, and children.
Results:
Certain AEDs including carbamazepine, phenobarbital, phenytoin and valproic acid, as well as the presence of a homozygous 5-methylenetetrahydrofolate reductase polymorphism in the genotype, are potential causes of elevation in plasma homocysteine and serum lipoprotein concentrations.
Conclusions:
Persistent elevation in these biochemical markers has shown to be associated with the development of long-term sequelae such as cardiovascular diseases, prompting concerns about the long-term implications of chronic AED use in children and cardiovascular risk. Further research is needed to assess the relationship between specific chronic AED use, homocysteine and lipoprotein concentrations, the influence of genotype, as well as the risk of long-term sequelae in the paediatric population.
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