Department of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Wallenberg Center of Molecular and Translational Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Brain Behav. 2022 Aug;12(8):e2699. doi: 10.1002/brb3.2699. Epub 2022 Jul 8.
Congenital heart disease (CHD) is the most common congenital defect, and reports suggest an increased risk of subsequent epilepsy. We used Swedish comprehensive population-based registers to investigate the risk of epilepsy in patients with CHD compared to matched controls and identify underlying factors of epilepsy.
All patients with CHD born between 1970 and 2017 and 10 age- and sex-matched controls were included. Epilepsy was ascertained by International Statistical Classification of Diseases and Related Health Problems codes, and the cumulative hazard of epilepsy was described using Cox regression.
The study cohort consisted of 71,941 patients with CHD and 714,462 matched controls. The cumulative incidence of epilepsy in the study period was 3% in patients with CHD and 0.9% in controls. The risk of epilepsy was 3.6 times higher (95%, confidence interval: 3.4-3.8) in patients with CHD than in controls. Among patients with CHD, several brain comorbidities, including intellectual disability and stroke, as well as having undergone more than two cardiac interventions were significantly associated with epilepsy in a multivariable model.
In this nationwide, register-based cohort study, we found an almost fourfold increased risk of epilepsy in patients with CHD compared to controls; however, the absolute risk was low. Among the identified risk factors, stroke may be potentially preventable.
先天性心脏病（CHD）是最常见的先天性缺陷，有报道称其后续癫痫风险增加。我们使用瑞典综合人群为基础的登记处，调查 CHD 患者与匹配对照者相比癫痫的风险，并确定癫痫的潜在因素。
纳入 1970 年至 2017 年出生的所有 CHD 患者和 10 名年龄和性别匹配的对照者。癫痫通过国际疾病分类和相关健康问题编码确定，使用 Cox 回归描述癫痫的累积风险。
研究队列包括 71941 例 CHD 患者和 714462 名匹配对照者。研究期间，CHD 患者的癫痫累积发病率为 3%，对照组为 0.9%。CHD 患者癫痫的风险比对照组高 3.6 倍（95%置信区间：3.4-3.8）。在 CHD 患者中，多种脑部合并症，包括智力残疾和中风，以及接受两次以上心脏介入治疗，在多变量模型中与癫痫显著相关。
在这项全国范围内基于登记的队列研究中，我们发现 CHD 患者癫痫的风险比对照组增加近四倍；然而，绝对风险较低。在确定的风险因素中，中风可能是可以预防的。
