{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T20:02:40Z","timestamp":1791576160133,"version":"4.3.4"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2010,12,9]],"date-time":"2010-12-09T00:00:00Z","timestamp":1291852800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2011,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Patients with epilepsy have increased risk of myocardial infarction (MI). Valproate can exert anti\u2010atherosclerotic effects. We therefore examined the risk of MI in patients with epilepsy receiving valproate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two cohorts of patients with valproate\u2010treated epilepsy and sex\u2010 and age\u2010matched individuals (controls) from the general Danish population were identified by individual\u2010level\u2010linkage of nationwide registries and followed for 10 years. The two cohorts comprised patients treated with valproate at baseline and valproate\u2010na\u00efve patients initiating treatment in the study period, respectively. The hazard ratios (HR) of MI and all\u2010cause death were estimated by two different Cox proportional\u2010hazard models; valproate treatment was analysed as a baseline categorical covariate in the first cohort and as a time\u2010dependent exposure covariate in the second cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The two cohorts comprised 53\u2009086 and 102\u2009003 individuals, respectively. In the first cohort, the risk of MI was decreased (HR 0.75, 95% confidence interval 0.59\u22120.97) while the risk of all\u2010cause death was increased (HR 2.11, 95% confidence interval 1.95\u22122.28), compared to the controls. In the second cohort, the risk of MI was decreased (HR 0.62, 95% confidence interval 0.53\u22120.73) while the risk of all\u2010cause death was similar to the controls (HR 1.02, 95% confidence interval 0.97\u22121.07).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this nationwide pharmacoepidemiological study, we found a consistent association between valproate treatment and a reduced risk of MI in patients with epilepsy. 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