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Comparative cardiovascular safety of dementia medications: a cross-national study.

Publication ,  Journal Article
Fosbøl, EL; Peterson, ED; Holm, E; Gislason, GH; Zhang, Y; Curtis, LH; Køber, L; Iwata, I; Torp-Pedersen, C; Setoguchi, S
Published in: J Am Geriatr Soc
December 2012

OBJECTIVES: To compare the cardiovascular safety of currently marketed dementia medications in new users in the United States and Denmark. DESIGN: Retrospective cohort study. SETTING: Nationally representative sample of Medicare beneficiaries from 2006 through 2009 and nationwide Danish administrative registries from 1997 through 2007. PARTICIPANTS: Individuals treated with a dementia medication aged 65 and older. MEASUREMENTS: Hospitalizations for myocardial infarction (MI), heart failure, and syncope or atrioventricular block in both cohorts; fatal or nonfatal MI and cardiac death in the Danish cohort; and all-cause mortality in sensitivity analyses. RESULTS: In 46,737 Medicare beneficiaries and 29,496 Danish participants, donepezil was the most frequently used medication. There were no substantial differences in the risk of MI or heart failure between participants using donepezil and those using other cholinesterase inhibitors (all hazard ratios (HR) crossing 1). In the Danish cohort, memantine was associated with fatal or nonfatal MI (HR = 1.33, 95% confidence interval (CI) = 1.08-1.63), cardiac death (HR = 1.31, 95% CI = 1.12-1.53), and a trend toward higher rates of hospitalization for MI (HR = 1.31, 95% CI = 0.98-1.76). Memantine was also associated with greater risk of all-cause mortality in the Medicare (HR = 1.20, 95% CI = 1.13-1.28) and Danish (HR = 1.83, 95% CI = 1.73-1.94) cohorts, suggesting that sicker individuals were selected for memantine therapy. CONCLUSION: Cholinesterase inhibitors have similar cardiovascular risk profiles. Associations between memantine and fatal outcomes in Denmark may be related, in part, to selection of sicker individuals for memantine therapy.

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Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

December 2012

Volume

60

Issue

12

Start / End Page

2283 / 2289

Location

United States

Related Subject Headings

  • United States
  • Receptors, N-Methyl-D-Aspartate
  • Piperidines
  • Nootropic Agents
  • Myocardial Infarction
  • Memantine
  • Medicare
  • Male
  • Indans
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
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Fosbøl, E. L., Peterson, E. D., Holm, E., Gislason, G. H., Zhang, Y., Curtis, L. H., … Setoguchi, S. (2012). Comparative cardiovascular safety of dementia medications: a cross-national study. J Am Geriatr Soc, 60(12), 2283–2289. https://doi.org/10.1111/j.1532-5415.2012.04241.x
Fosbøl, Emil L., Eric D. Peterson, Ellen Holm, Gunnar H. Gislason, Yinghong Zhang, Lesley H. Curtis, Lars Køber, Isao Iwata, Christian Torp-Pedersen, and Soko Setoguchi. “Comparative cardiovascular safety of dementia medications: a cross-national study.J Am Geriatr Soc 60, no. 12 (December 2012): 2283–89. https://doi.org/10.1111/j.1532-5415.2012.04241.x.
Fosbøl EL, Peterson ED, Holm E, Gislason GH, Zhang Y, Curtis LH, et al. Comparative cardiovascular safety of dementia medications: a cross-national study. J Am Geriatr Soc. 2012 Dec;60(12):2283–9.
Fosbøl, Emil L., et al. “Comparative cardiovascular safety of dementia medications: a cross-national study.J Am Geriatr Soc, vol. 60, no. 12, Dec. 2012, pp. 2283–89. Pubmed, doi:10.1111/j.1532-5415.2012.04241.x.
Fosbøl EL, Peterson ED, Holm E, Gislason GH, Zhang Y, Curtis LH, Køber L, Iwata I, Torp-Pedersen C, Setoguchi S. Comparative cardiovascular safety of dementia medications: a cross-national study. J Am Geriatr Soc. 2012 Dec;60(12):2283–2289.
Journal cover image

Published In

J Am Geriatr Soc

DOI

EISSN

1532-5415

Publication Date

December 2012

Volume

60

Issue

12

Start / End Page

2283 / 2289

Location

United States

Related Subject Headings

  • United States
  • Receptors, N-Methyl-D-Aspartate
  • Piperidines
  • Nootropic Agents
  • Myocardial Infarction
  • Memantine
  • Medicare
  • Male
  • Indans
  • Humans