{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:30:56Z","timestamp":1779892256050,"version":"3.53.1"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T00:00:00Z","timestamp":1690502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Korea Health Technology R&amp;D","award":["HR22C1605030022"],"award-info":[{"award-number":["HR22C1605030022"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Cardiotoxicity from first-generation H1-antihistamines has been debated since the 1990s. However, large-scale studies on this topic in a general pediatric population are lacking. This study aimed to assess the association between first-generation H1-antihistamine use and cardiovascular events in a nationwide pediatric population. In this case-crossover study, the main cohort included children with cardiovascular events from the National Health Insurance Service database (2008\u20132012 births in Korea) until 2018. The second cohort excluded children with specific birth histories or underlying cardiovascular diseases from the main cohort. Cardiovascular events of interest included cardiac arrhythmia and ischemic heart disease. Odds ratios (ORs) of cardiovascular events were estimated using conditional logistic regression models, comparing first-generation H1-antihistamine use during 0\u201315 days before cardiovascular events (hazard period) with use during 45\u201360 and 75\u201390 days before events (control periods). Among the participants, 1194 (59.9%) were aged 24 months to 6 years, and 1010 (50.7%) were male. Cardiovascular event risk was increased among users of first-generation H1-antihistamines (adjusted OR [aOR], 1.201; 95% confidence interval, 1.13\u20131.27). Significant odds of cardiovascular events persisted within 10 and 5 days (aOR, 1.25 and 1.25). In the second cohort, the association was comparable with that in the main cohort. Our findings indicate that cardiovascular event risk is increased in children who are administered first-generation H1-antihistamines.<\/jats:p>","DOI":"10.3390\/ph16081073","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T07:35:24Z","timestamp":1690529724000},"page":"1073","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Association between First-Generation Antihistamine Use in Children and Cardiac Arrhythmia and Ischemic Heart Disease: A Case-Crossover Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4945-0753","authenticated-orcid":false,"given":"Ju Hee","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Kyung Hee University Medical Center, Seoul 02447, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0459-7655","authenticated-orcid":false,"given":"Hye Ryeong","family":"Cha","sequence":"additional","affiliation":[{"name":"Department of Computer Science and Engineering, Sungkyunkwan University, Suwon 16419, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8863-5729","authenticated-orcid":false,"given":"Eun Kyo","family":"Ha","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kangnam Sacred Heart Hospital, Seoul 07441, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6376-0427","authenticated-orcid":false,"given":"Ji Hee","family":"Kwak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakjun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Hwacheon County Health and Medical Center, Hwacheon 24119, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5179-4013","authenticated-orcid":false,"given":"Jeewon","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Mi","family":"Jee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9077-5779","authenticated-orcid":false,"given":"Man Yong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam 13496, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1136\/archdischild-2013-304446","article-title":"Antihistamine use in children","volume":"100","author":"Fitzsimons","year":"2015","journal-title":"Arch. 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