Could cholesterol-lowering agents be used to reduce risk of seizures in people with cardiovascular disease?
Results of a new statistical study from a drug safety expert at the University of British Columbia and Vancouver Coastal Health Research Institute show that cholesterol-lowering statins could also be used to reduce risk for epileptic seizures in patients with cardiovascular disease. The study may pave the way for a randomized, controlled trial to test the efficacy of these agents as anti-epileptics.
Culling information on 2,400 residents of Quebec, Canada who were age 65 years and older from a larger database of 150,000 cardiovascular patients in Quebec, the study—published in Neurology—found that patients who took statins were 35% less likely to be hospitalized with an epilepsy diagnosis than patients who were not on statins. Though the study reveals an association between statin use and epiplepsy incidence, the findings don’t prove causation. However, making the association is a crucial step on the road to conducting clinical trials.
Though previous studies have shown that atorvastatin can decrease seizures and neuron death in rates and that statins have a protective effect in such disorders as multiple sclerosis and spinal cord injury, the current study is the first large study to look at the correlation between statins and seizures in humans.
"Our data is compelling in that it opens doors for future studies to test this hypothesis in patients with epilepsy," said lead author Dr. Mahyar Etminan, pharmacoepidemiologist, Centre for Clinical Epidemiology, Vancouver Coastal Health Research Institute, and assistant professor, Deptartment of Medicine, UBC. "Such trials would show whether statins truly have a protective effect, and if that effect is limited to certain types of statins or certain types of epilepsy."
Co-author Dr. Ali Samii, professor, Department of Neurology, University of Washington, added to Etminan’s sentiments. "Our study suggests that statin use reduces the risk of developing epilepsy in persons over the age of 65 with cardiovascular disease," said Samii. "The most plausible explanation is that statin use reduces the risk of stroke in this population, and since strokes can increase the risk of epilepsy, statins reduce the risk of epilepsy because of stroke prevention."
However, Samii noted that other cardiovascular drug classes—such as ACE inhibitors and beta-blockers—that reduce stroke risk don’t show the same effect with seizures as do statins. Thus, the mechanism by which statins reduce the risk of epilepsy in cardiovascular patients may by outside of stroke prevention.
Could statins become the next set of anti-epileptic drugs? Do you think they possible effects these agents have on seizures will be seen outside of patients with cardiovascular disease? What can neurologists and cardiologists do with this information? Tell us what you think. Post a comment below.