Incident late-onset epilepsy and incident myocardial infarction demonstrated bidirectional associations, suggesting late-onset epilepsy may be a marker of increased systemic vascular risk (P<0.001).
Cohort
Is there a bidirectional association between late-onset epilepsy and myocardial infarction or nonstroke vascular death in stroke-free middle-aged and older adults?
Late-onset epilepsy and myocardial infarction share a bidirectional association, suggesting that late-onset epilepsy may serve as a clinical marker for increased systemic vascular risk.
p-value: p=<0.001
BACKGROUND AND OBJECTIVES: Cerebrovascular disease is associated with increased risk of late-onset epilepsy (LOE). Because vascular disease is often systemic, coexisting in multiple vascular beds, LOE may be a marker of increased systemic vascular risk outside the brain. We sought to determine whether stroke-free middle-aged and older adults with incident myocardial infarction (MI) subsequently have increased risk of LOE and whether those with incident LOE subsequently have increased risks of incident MI and nonstroke vascular death. METHODS: The Northern Manhattan Study (NOMAS) is a population-based cohort study of participants aged 40 years and older enrolled from 1993 to 2008, with follow-up through May 2023 for the present analysis. Participants free of a history of stroke, MI, or epilepsy at enrollment were followed prospectively for up to 30 years (mean 14 years). We used Cox proportional hazards regression with censoring at incident stroke to assess the associations of (1) incident MI with subsequent incident LOE; (2) incident LOE with subsequent incident MI; and (3) incident LOE with nonstroke cardiovascular death, adjusting for demographics, health behaviors, and comorbid diagnoses. RESULTS: < 0.001). Sensitivity analyses yielded similar results. DISCUSSION: The bidirectional associations we observed suggest that LOE might be a marker of increased systemic vascular risk. This warrants further study in additional populations.
Thacker et al. (2025) conducted a cohort in Late-onset epilepsy and myocardial infarction. Incident late-onset epilepsy and incident myocardial infarction vs. Participants without incident LOE or MI was evaluated on Incident LOE, incident MI, and nonstroke cardiovascular death (p=<0.001). Incident late-onset epilepsy and incident myocardial infarction demonstrated bidirectional associations, suggesting late-onset epilepsy may be a marker of increased systemic vascular risk (P<0.001).