Coronary disease & ACSResearch article
Association between recently raised anticholinergic burden and risk of acute cardiovascular events: nationwide case-case-time-control study
- Case-case-time-control study
- nationwide
- case crossover and control crossover (future cases) design
Authors' conclusion
An association was found between recently raised anticholinergic burden and increased risk of acute cardiovascular events. Furthermore, a greater increase in anticholinergic burden was associated with a higher risk of acute cardiovascular events.
Study context
- Population
- Adults aged ≥65 admitted to hospital for an incident acute CV event (MI, stroke, arrhythmia, conduction disorder, CV death), Taiwan's National Health Insurance Research Database, 2011–2018248,579 current cases analysed
- Participants
- 317,446 adults
- Comparison
- Recently raised anticholinergic burden vs lower burden
- Outcome
- Acute CV events by anticholinergic burden in hazard period (day −1 to −30) vs 30-day reference periods (days −61 to −180)
Main finding
As reported in the abstract
Acute CV events
Estimate (95% CI)
1-2 points vs 0 pointscase crossover OR 1.86 (1.83 to 1.90); control crossover OR 1.35 (1.33 to 1.38)
case-case-time-control OR 1.38(1.34–1.42)
≥3 points vs 0 points
OR 2.03(1.98–2.09)
≥3 points vs 1-2 points
OR 1.48(1.44–1.52)
Further findings
Discordant burden levels between periods
- 1-2 points in hazard period with 0 points in reference period
- 17 603
- 0 points in hazard period with 1-2 points in reference period
- 8507
Sensitivity analyses
- Findings remained consistent (redefined cut-off points, different scales)
Original publication
Association between recently raised anticholinergic burden and risk of acute cardiovascular events: nationwide case-case-time-control study. BMJ. Published 27 September 2023. doi:10.1136/bmj-2023-076045
Summarised from the published abstract; every number is checked against it