Abstract

Anti-Dementia Drugs and Risk of Cardiovascular Events-A Nationwide Cohort Study in Taiwan

Author(s): Fang-Jung Wan, Wu-Chien Chien, Chi-Hsiang Chung, Hsin-An Chang, Yu-Cheng Kao, Nian-Sheng Tzeng

Objectives

Previous studies have reported that anti-dementia drugs could be associated with a lower risk of heart diseases and death. This retrospective cohort study is to investigate the association between the long-term effects of the anti-dementia drugs (ADD) usage and the cardiovascular adverse events (CVE’s).

Methods

Subjects were conducted from January 1, 2000, through December 31, 2013, using Taiwan’s National Health Insurance Research Database (NHIRD). We enrolled a total of 45,020 subjects, and identified 22,510 patients with ADD usage and randomly selected the propensity scorematched controls without ADD usage in a ratio of 1:1. The Fine and Gray’s survival analysis was used to evaluate the risk of developing CVE in the ADD usage cohort.

Results

A risk reduction of angina pectoris in an ADD usage cohort was found: crude hazard ratio (HR)=0.705 (95% CI: 0.631-0.788, p<0.001) and adjusted HR=0.766 (95% CI: 0.683—0.858, p<0.001), in the 13 years of follow up. However, only the short-term, within one year, associations between the individual cholinesterase inhibitors usage and a lower risk of myocardial infarction and ischemic stroke, without the same effects of long-term follow up. No association between the ADD usage and the lower risk of death.

Conclusion

The usage of the ADD was associated with a decreased risk of angina pectoris, but not other CVE’s such as myocardial infarction and ischemic stroke, or death, in such a long-term follow up study.