Antiepileptik ilaçlarla uzun süreli tedavinin aterosklerozun bir göstergesi olarak karotis intima-media kalınlığı üzerine etkisi

Year 2024, Volume: 49 Issue: 4, 947 - 957, 30.12.2024

Elif Banu Söker , Selda Keskin Güler , Işık Conkbayır , Bülent Güven , Tahir Yoldaş

https://doi.org/10.17826/cumj.1489920

Abstract

Amaç: Bu çalışmada, antiepileptik ilaç (AED) ile aterosklerotik risk faktörleri ve aterosklerozun bir belirteci olarak karotis intima media kalınlığı (IMT) arasındaki olası ilişkiyi araştırmayı amaçladık.
Gereç ve Yöntem: Üç yıl veya daha uzun süredir karbamazwpin (CBZ) ve valproik asit (VPA) kullanan ve CBZ veya VPA monoterapisine ek olarak iki yıl boyunca ikinci bir AEİ (politerapi) kullanan 92 hasta çalışmaya dahil edildi. Kontrol grubu benzer demografik özelliklere sahip 31 denekten oluşmuştur. Her iki grupta da açlık kan şekeri, karaciğer ve böbrek fonksiyon testleri, lipid profili, homosistein, serum yüksek hassasiyetli C-Reaktif Protein (Hs-CRP), ürik asit (UA), lipoprotein (a) (Lp (a)), folat ve vitamin B12 düzeyleri incelendi.
Bulgular: Homosistein düzeyleri VPA, CBZ ve politerapi gruplarında kontrol grubuna göre daha yüksekti. ÜA düzeyleri VPA monoterapi grubunda CBZ monoterapi ve politerapi grubuna kıyasla daha yüksekti. CBZ monoterapi grubunda Hs-CRP düzeyleri VPA monoterapi, politerapi ve kontrol gruplarına göre daha yüksekti. Total kolesterol düzeyleri CBZ monoterapi grubunda VPA monoterapi ve kontrol gruplarına kıyasla daha yüksekti.
Sonuç: Bulgular IMT değerleri ile hastalık süresi, ilaç kullanım süresi ve dozu arasında bir korelasyon olmadığını göstermiştir; bu da uzun süreli AEİ kullanımının ateroskleroz gelişimini artırmadığını düşündürmektedir.

Keywords

Epilepsi, antiepileptik ilaçlar, ateroskleroz, karotis intima media kalınlığı

Effect of long term treatment with antiepileptic drugs on carotid intima-media thickness as an indicator of atherosclerosis

Abstract

Purpose: The aim of current study was to investigate the possible relation between antiepileptic drugs (AEDs) and atheosclerotic risk factors and carotid intima media thickness (IMT) as a marker of atherosclerosis.
Materials and Methods: Ninety-two patients, who had used carbamazepine (CBZ) and valproic acid (VPA) for three or more years and who had used a second AED (polytherapy) for two years in addition to CBZ or VPA monotherapy, were included in the study. The control group was composed of 31subjects with similiar demographics. Fasting blood glucose, liver and renal function tests, lipid profile, homocysteine, serum high sensitivity C-Reactive Protein (Hs-CRP), uric acid (UA), lipoprotein (a) (Lp (a)), folate and vitamine B12 levels were examined in both groups.
Results: Homocysteine levels were higher in the VPA, CBZ and politherapy groups compared to the control group. UA levels were higher in the VPA monotherapy group when compared to the CBZ monotherapy and polytherapy group. In the CBZ monotherapy group, Hs-CRP levels were higher than in the VPA monotherapy, polytherapy and control groups. Total cholesterol levels were higher in the CBZ monotherapy group when compared to the VPA monotherapy and control groups.
Conclusion: The findings showed no correlation between IMT values and duration of disease, duration of drug usage and dose, which suggests that long-term AED usage does not increase the development of atherosclerosis.

Keywords

antiepileptic drugs, intima media thickness, IMT, atherosclerosis, politherapy

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