For older patients treated with cholinesterase inhibitors, taking antipsychotic agents (APs) for dementia is associated with a modest and time-limited increased risk of myocardial infarction (MI), according to a study published online March 26 in the Archives of Internal Medicine.
Antoine Pariente, MD, PhD, of the Université de Montreal, and colleagues retrospectively identified a cohort of 37,138 community-dwelling older patients who initiated cholinesterase inhibitor treatment based on the Quebec, Canada, prescription claims database from 2000 through 2009. The cohort included 10,969 new AP users who were matched with a random sample of AP nonusers.
The researchers found that, within one year of initiating AP treatment, 1.3 percent of new users had an incident MI. There was an increased risk of MI after initiation of AP treatment, with a hazard ratio of 2.19 in the first 30 days, 1.62 in the first 60 days, 1.36 in the first 90 days, and 1.15 for the first year. The incidence rate ratios in a self-controlled case series study conducted among 804 incident cases of MI among new AP users were 1.78 for the one- to 30-day period, 1.67 for the 31- to 60-day period, and 1.37 for the 61- to 90-day period.
"Antipsychotic use is associated with a modest and time-limited increase in the risk of MI among community-dwelling older patients treated with cholinesterase inhibitors," the authors write.
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