commonly prescribed dementia drug puts patients at twice the risk of being hospitalized for a potentially life-threatening heart condition, Canadian researchers say.

The study was based on the health records of more than 1.4 million Ontario, Canada adults ages 67 and older and conducted by officials at St. Michael’s Hospital in Toronto. The researchers found a link between the initiation of cholinesterase inhibitor therapy and bradycardia, a condition in which the heart beats slower than the normal rate of 60 beats per minute.

In the study, patients taking the dementia drug Aricept (known generically as donepezil) were more than twice as likely to be hospitalized with bradycardia, which usually is treated with an implanted pacemaker to help maintain a proper heart rate.

The Canadian study is published in the September issue of the journal PLoS Medicine, according to a UPI Health report.
Aricept (Donepezil) Linked to Heart Disease Risks

The study identified 161 patients with an average age of 83 who were either hospitalized or treated in an emergency department for bradycardia within nine months of taking a cholinesterase inhibitor. Nearly three out of four of those were taking Aricept.

Overall, 11 percent of the patients required a pacemaker during hospitalization and four percent died prior to discharge, the study found.

Aricept helps improve brain functioning by preventing the breakdown of an enzyme called acetylcholine, which is necessary for memory, thinking, and reasoning and linked to dementia when found in low levels in the brain. It is approved to treat mild to moderate dementia caused by Alzheimer’s disease.

http://www.attorneyatlaw.com/2...ry-hospitalizations/

It would appear, Guy, that these medical malpractice lawyers didn't bother to read the entire paper, including the Editors' Summary, which is right after the abstract and which says:

"A population-based study like this cannot prove that cholinesterase inhibitors cause bradycardia."

It also says: "It was not possible to compare risk for different cholinesterase inhibitors because most patients took donepezil."

Now, the interesting thing about this "study" is that all patients who were included in the analysis had taken cholinesterase inhibitors, both those who were diagnosed with bradycardia and those who were not. And the researchers made the assumption that if the ChEI were going to cause bradycardia, it would do so within a few weeks of initiating treatment. So they compared patients who had just started ChEI therapy within 3 months prior to going to the hospital where it was noticed that they had bradycardia against those who had been taking ChEI therapy for an unknown period of time but stopped taking it (for unknown reasons) at least 3 months prior to going to the hospital where it was noticed that they had bradycardia. (They assumed that if a patient was being prescribed a cholinesterase inhibitor, that the patient was actually taking the cholinesterase inhibitor in accordance with the directions given by the doctor.)

The controls, then, were patients who had just started ChEI therapy within 3 months prior to an arbitrary point in time and those who had been taking ChEI therapy for an unknown period of time but stopped taking it (for unknown reasons) at least 3 months prior to an arbitrary point in time, and who did not happen to have bradycardia at the time they visited the hospital.

So then the ratio of the "just started taking" to "stopped a while back" for those who happened to have bradycardia was compared to the ratio of the "just started taking" to "stopped a while back" for those who did not happen to have bradycardia, and that ratio was roughly 2:1.

I hope you understand that, because I don't.

If I understand what they did correctly -- which is hard to do because they keep saying contradictory things -- out of 1.4 million patients over the age of 67, they identified 27,333 who visited a hospital for any reason whatsoever who happened to have bradycardia at the time. (Note, please, that the bradycardia was not necessarily the reason the patient visited the hospital. A pulse below 60 doesn't exactly always necessitate a trip to the ER.) Out of these, as many as 26,037 had never taken ChEIs. That's more than 95% of the patients with bradycardia who never took ChEIs.

And there's absolutely no way to determine the percentage of patients who did take ChEIs who never developed bradycardia that required any form of treatment.

I also noted that these researchers recommended, based on this study, that if patients do not improve immediately upon being prescribed aricept, they should immediately be taken back off the aricept, in order to avoid the slightest possibility that they might develop bradycardia within the next three months.

Aside from that, this is a very logical analysis. (Not.)

These are, by the way, the same malpractice lawyers who say that dimebon is a dangerous drug because Abeta levels rose -- possibly only temporarily -- in interstitial fluid in the brains of genetically engineered mice.

What was really sad to me was that someone read that information on that site, took it at face value and then asked if Galantamine might have the same risk. Hopefully, the person who posted that question to the lawyer will ask his doctor for advice and not the malpractice attorney.
Bradycardia is so common in the elderly, I think they're going to have a really hard time proving that aricept causes bradycardia. (I know it's not statistically meaningful, but my Grandma had bradycardia long before she started aricept.)