{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:57:17Z","timestamp":1790755037889,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG6H0623"],"award-info":[{"award-number":["CMRPG6H0623"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPVVL0211"],"award-info":[{"award-number":["CMRPVVL0211"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CORPVVN0021"],"award-info":[{"award-number":["CORPVVN0021"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epileptic Disorders"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine whether enzyme\u2010inducing anti\u2010seizure medications (EIASMs) are associated with differential risks of major adverse cardiovascular events (MACE) and all\u2010cause mortality compared with non\u2010enzyme\u2010inducing anti\u2010seizure medications (NEIASMs) in adults with epilepsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the Chang Gung Research Database (2010\u20132019), adults with epilepsy receiving at least 28 cumulative days of anti\u2010seizure medication therapy within 180\u2009days of the index date were classified as EIASMs or NEIASMs users. Stabilized inverse probability of treatment weighting (IPTW) addressed confounding by indication. Composite MACE encompassing myocardial infarction (MI), arrhythmia, heart failure, ischemic stroke, hemorrhagic stroke, and sudden cardiac death and all\u2010cause mortality were co\u2010primary endpoints evaluated using Cox proportional hazards and Fine\u2013Gray competing risk models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 20\u2009693 eligible patients, 10\u2009571 received EIASMs and 10\u2009122 received NEIASMs. After IPTW, all covariates were balanced (absolute standardized mean differences &lt;0.1). Cox analysis demonstrated lower composite MACE (adjusted HR: 0.91, 95% CI: 0.85\u20130.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020) and all\u2010cause mortality (adjusted HR: 0.95, 95% CI: 0.89\u20131.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048) with EIASM use, with individually lower rates of MI (adjusted HR: 0.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.013) and arrhythmia (adjusted HR: 0.85,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.029). Under Fine\u2013Gray modeling, composite MACE was attenuated to nonsignificance (adjusted SHR 0.94, 95% CI: 0.87\u20131.01,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.118), with directional consistency preserved.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In this large propensity score\u2010weighted Asian cohort, EIASM use was not associated with excess cardiovascular risk. These findings challenge the assumption that EIASMs carry inherent cardiovascular disadvantage and support their use with appropriate monitoring when seizure control requires enzyme\u2010inducing therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/epd2.70430","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:05:28Z","timestamp":1790751928000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular outcomes of enzyme\u2010inducing anti\u2010seizure medications: A real\u2010world Asian cohort study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2233-2666","authenticated-orcid":false,"given":"Chun\u2010Yu","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Chang Gung Memorial Hospital  Chiayi Taiwan"},{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2017-6201","authenticated-orcid":false,"given":"Ting\u2010Chung","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Chang Gung Memorial Hospital  Chiayi Taiwan"},{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9288-0329","authenticated-orcid":false,"given":"Chia\u2010Yu","family":"Hsu","sequence":"additional","affiliation":[{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Department of Neurology Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8594-3360","authenticated-orcid":false,"given":"Meng\u2010Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Health Information and Epidemiology Laboratory Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Yen","family":"Liu","sequence":"additional","affiliation":[{"name":"Health Information and Epidemiology Laboratory Chang Gung Memorial Hospital  Chiayi Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9573-969X","authenticated-orcid":false,"given":"Chih\u2010Hao","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine Jen Ai Hospital  Taichung Taiwan"},{"name":"Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine New Taipei Municipal Tucheng Hospital  New Taipei City Taiwan"},{"name":"Department of Thoracic Medicine Chang Gung Memorial Hospital Linkou Branch  Taoyuan 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