Acute cardiac care & resuscitation
Use of methylphenidate is associated with increased risk of out-of-hospital cardiac arrest in the general population: a nationwide nested case-control study
Main finding · OHCAResult — go to the resultOdds ratio 1.78 95% CI 1.32–2.40Authors' conclusion
Methylphenidate use is associated with an increased risk of OHCA in the general population. This increased risk applies to both sexes and is independent of age and the presence of cardiovascular disease.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) cases of presumed cardiac causes and matched non-OHCA controls from the Danish general population46,578 cases
- Comparison
- Methylphenidate use vs no use
- Outcome
- OHCA
Methodological detailsnationwide, Danish registries, age/sex/OHCA-date-matched controls, conditional logistic regression
- Nationwide
- Danish registries
- age/sex/OHCA-date-matched controls
- Conditional logistic regression
Main finding
As reported in the abstract
Odds ratio
1.78
95% CI 1.32–2.40
Methylphenidate usevs No use
OR 1.78 (95% CI 1.32–2.40)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| OHCA, recent starters (≤180 days) | 2.59 (1.28–5.23) | |
| OHCA, sensitivity analysesMethylphenidate usevs No useWithout registered hospital-based ADHD | 1.85 (1.34–2.55) | |
| OHCA, sensitivity analysesMethylphenidate usevs No useWithout severe psychiatric disorders | 1.98 (1.46–2.67) | |
| OHCA, sensitivity analysesMethylphenidate usevs No useWithout depression | 1.93 (1.40–2.65) | |
| OHCA, sensitivity analysesMethylphenidate usevs No useNon-users of QT-prolonging drugs | 1.79 (1.27–2.54) | |
| 0.20.5125Odds ratio (log scale) |
OHCA by age, sex and pre-existing CVD (subgroups)
- No significant variation by age
- P-value interaction: 0.37
- No significant variation by sex
- P-value interaction: 0.94
- No significant variation by pre-existing CVD
- P-value interaction: 0.27
Original publication
Use of methylphenidate is associated with increased risk of out-of-hospital cardiac arrest in the general population: a nationwide nested case-control study. Eur Heart J Cardiovasc Pharmacother. Published 17 April 2023. doi:10.
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