Acute cardiac care & resuscitationResearch article

Transient anticholinergic burden and out-of-hospital cardiac arrest: a case-crossover study

Eur Heart JPublished

  • Case-crossover study
  • nationwide
  • case-time-control
  • case-case-time-control

Authors' conclusion

Transient increases in anticholinergic burden significantly raise OHCA risk, particularly among individuals with higher burden levels.

Study context

Population
Adults aged ≥40 years with OHCA, 2011–2021, Taiwan National Health Insurance Research Database; middle-aged (40–64 years) or older (≥65 years)
Participants
173,974 adults
Comparison
Anticholinergic burden score 1-2 and ≥3 vs 0
Outcome
OHCA risk by anticholinergic burden in hazard period (days −30 to −1) vs 30-day reference period (days −180 to −61)

Main finding

As reported in the abstract

OHCA
Odds ratio (95% CI)
Score 1-2 vs Score 0middle-aged
1.48(1.42–1.55)
Score 1-2 vs Score 0older
1.56(1.52–1.61)
Score ≥3 vs Score 0middle-aged
2.03(1.95–2.11)
Score ≥3 vs Score 0older
2.21(2.15–2.27)

Further findings

Case-time-control and case-case-time-control analyses

Consistent dose-response relationship, confirmed by sensitivity analyses

Original publication

Transient anticholinergic burden and out-of-hospital cardiac arrest: a case-crossover study. Eur Heart J. Published 25 September 2025. doi:10.1093/eurheartj/ehaf723

Summarised from the published abstract; every number is checked against it