Howaida Elmowafi, Jenny M Kindblom, Linda Halldner, David Gyllenberg, Estelle Naumburg
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引用次数: 0
摘要
目的:人们一直关注儿童和年轻人的注意力缺陷多动障碍(ADHD)药物治疗与心脏事件之间的联系。我们的目的是找出任何关联。方法:这项瑞典病例对照研究使用国家登记数据来确定2006-2018年期间首次被诊断为心脏骤停、心律失常、昏厥或崩溃的5-30岁个体。每个病例按年龄、性别和地区与5个对照组相匹配。使用校正优势比(aORs)和95%可信区间(CIs)评估ADHD药物与心脏事件之间的关联。对合并用药和合并症(包括先天性心脏病)进行了调整。结果:我们研究了112 605例(57.9%为女性),中位年龄为20岁(范围5-30岁),以及563 024例匹配的对照组。在性别和年龄组中,使用ADHD药物与心脏事件相关(aOR 1.63, 95% CI 1.47-1.81)。未明确的心律失常相关性最强(aOR 2.66, 95% CI 2.27-3.13)。心脏骤停和明确的心律失常没有关联。长期用药与风险增加相关(aOR 1.20, 95% CI 1.12-1.28)。冠心病没有影响。结论:ADHD药物治疗与心脏事件有关,尤其是不明确的心律失常。冠心病没有增加风险。
Children and Young Adults Who Used Medication for Attention Deficit Hyperactivity Disorder Faced Increased Cardiac Risks.
Aim: There have been concerns about links between medication for attention deficit hyperactivity disorder (ADHD) and cardiac events in children and young people. Our aim was to identify any associations.
Method: This Swedish case-control study used national register data to identify individuals aged 5-30 years who received their first diagnosis of a cardiac arrest, arrhythmia, fainting or collapse in 2006-2018. Each case was matched with five controls, by age, sex and region. Associations between ADHD medication and cardiac events were assessed using adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Adjustments were made for concomitant medications and comorbidities, including congenital heart disease (CHD).
Results: We studied 112 605 cases (57.9% female), with a median age of 20 years (range 5-30), and 563 024 matched controls. Using ADHD medication was associated with cardiac events (aOR 1.63, 95% CI 1.47-1.81) across sexes and age groups. Undefined arrhythmias had the strongest association (aOR 2.66, 95% CI 2.27-3.13). Cardiac arrests and defined arrhythmias had no associations. Long-term medication was associated with an increased risk (aOR 1.20, 95% CI 1.12-1.28). CHD had no impact.
Conclusion: ADHD medication was associated with cardiac events, particularly undefined arrhythmias. CHD did not increase the risk.
期刊介绍:
Acta Paediatrica is a peer-reviewed monthly journal at the forefront of international pediatric research. It covers both clinical and experimental research in all areas of pediatrics including:
neonatal medicine
developmental medicine
adolescent medicine
child health and environment
psychosomatic pediatrics
child health in developing countries