Abstract：
Research on cerebrovascular events in atrial fibrillation (AF) patients taking non-vitamin K antagonist oral anticoagulants (NOACs) with antiseizure medications (ASMs) is limited, highlighting a significant gap in literature. We assessed thrombotic and hemorrhagic risks in patients on NOACs and ASMs versus those on NOACs or ASMs alone. We analyzed a retrospective cohort from five centers, including AF and epilepsy patients on both medications (n = 188), AF patients on NOACs (n = 298), and epilepsy patients on ASMs (n = 50), with a 3-year follow-up. Propensity score matching adjusted for cardiovascular risk differences. The primary outcomes were ischemic stroke, transient ischemic attack, and major bleeding. Results showed the ASM+NOAC group had a higher risk of primary outcomes compared to the NOAC-only group (5.68% vs. 1.18%, hazard ratio = 5.72, 95% confidence interval = 2.22-14.73), with no events in the ASM-only group. This suggests an increased risk for patients on combined NOAC and ASM therapy, underlining the need for careful drug interaction consideration.
摘要：
房颤（AF）患者服用非维生素K拮抗剂口服抗凝剂（NOACs）与抗癫痫药物（ASM）的脑血管事件研究有限，突出了文学上的巨大差距。我们评估了使用NOAC和ASM的患者与仅使用NOAC或ASM的患者的血栓形成和出血风险。我们分析了来自五个中心的回顾性队列，包括两种药物的房颤和癫痫患者（n=188），接受NOAC治疗的AF患者（n=298），和ASM上的癫痫患者（n=50），3年随访。倾向评分匹配调整了心血管风险差异。主要结果是缺血性卒中，短暂性脑缺血发作,大出血.结果显示，与仅NOAC组相比，ASM+NOAC组有更高的主要结局风险(5.68%vs.1.18%，危险比=5.72，95%置信区间=2.22-14.73)，仅ASM组中没有事件。这表明接受NOAC和ASM联合治疗的患者的风险增加，强调需要仔细考虑药物相互作用。
