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与伴随性心血管疾病或没有伴随性心血管疾病的痴呆症中与RISPERIDONE相关的中风风险:基于人口的匹配队列研究
Joshua Choma1, Alys Griffiths2, William Henley3
1Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, UK.
概括
里斯佩里会增加痴呆症患者中风的风险,特别是那些有心血管疾病史的人. 这种抗精神病药物具有显著的风险,需要对痴呆症患者进行仔细考虑.
科学领域:
- 老年医学 老年医学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 激动和攻击性影响到50%的痴呆症患者.
- 非药物干预是第一线的,但抗精神病药物如RISPERIDONE可用于严重的症状.
- 临床前数据表明,星与心血管疾病 (CVD) 途径的联系.
研究的目的:
- 在痴呆症患者中评估与RISPERIDONE相关的中风风险.
- 根据先前的中风和心血管疾病史,在各个子组中分析这种风险.
主要方法:
- 使用的英国临床实践研究数据链接匿名数据 (2004-2023年).
- 包括65岁以后被诊断患有痴呆症的个人.
- 在RISPERIDONE发起者和倾向性得分匹配的对照者之间比较1年的中风风险,分析具有和没有中风/心血管疾病史的子组.
主要成果:
- 里斯佩里的使用与中风风险增加有关 (aHR:1.28;95% CI:1.20-1.37).
- 与整体队列 (53.3/1000人年) 相比,里斯佩里使用者中风的发生率较高,他们之前曾有过中风 (222/1000人年) 和心血管疾病 (94.1/1000人年).
- 里斯佩里的相对中风风险在心血管疾病和中风史子组中一致 (HRs 1.23-1.44).
结论:
- 患有心血管疾病史的痴呆症患者面临明显更高的中风风险,而RISPERIDONE进一步增加了中风风险.
- 里斯佩里还会增加在没有心血管疾病病史的患者中中风的风险.
- 量化这种风险有助于为痴呆症患者做出明智的处方决定.
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