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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cardiovascular Safety of Stimulants in Children with Attention-Deficit/Hyperactivity Disorder: A Nationwide Prospective Cohort Study</title><author><name sortKey="Dalsgaard, S Ren" sort="Dalsgaard, S Ren" uniqKey="Dalsgaard S" first="S Ren" last="Dalsgaard">S Ren Dalsgaard</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation><affiliation><nlm:aff id="aff3"></nlm:aff></affiliation><affiliation><nlm:aff id="aff4"></nlm:aff></affiliation></author><author><name sortKey="Kvist, Anette Primdal" sort="Kvist, Anette Primdal" uniqKey="Kvist A" first="Anette Primdal" last="Kvist">Anette Primdal Kvist</name><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author><author><name sortKey="Leckman, James F" sort="Leckman, James F" uniqKey="Leckman J" first="James F." last="Leckman">James F. Leckman</name><affiliation><nlm:aff id="aff6"></nlm:aff></affiliation></author><author><name sortKey="Nielsen, Helena Skyt" sort="Nielsen, Helena Skyt" uniqKey="Nielsen H" first="Helena Skyt" last="Nielsen">Helena Skyt Nielsen</name><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author><author><name sortKey="Simonsen, Marianne" sort="Simonsen, Marianne" uniqKey="Simonsen M" first="Marianne" last="Simonsen">Marianne Simonsen</name><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24956171</idno><idno type="pmc">4137345</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4137345</idno><idno type="RBID">PMC:4137345</idno><idno type="doi">10.1089/cap.2014.0020</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000132</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000132</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Cardiovascular Safety of Stimulants in Children with Attention-Deficit/Hyperactivity Disorder: A Nationwide Prospective Cohort Study</title><author><name sortKey="Dalsgaard, S Ren" sort="Dalsgaard, S Ren" uniqKey="Dalsgaard S" first="S Ren" last="Dalsgaard">S Ren Dalsgaard</name><affiliation><nlm:aff id="aff1"></nlm:aff></affiliation><affiliation><nlm:aff id="aff2"></nlm:aff></affiliation><affiliation><nlm:aff id="aff3"></nlm:aff></affiliation><affiliation><nlm:aff id="aff4"></nlm:aff></affiliation></author><author><name sortKey="Kvist, Anette Primdal" sort="Kvist, Anette Primdal" uniqKey="Kvist A" first="Anette Primdal" last="Kvist">Anette Primdal Kvist</name><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author><author><name sortKey="Leckman, James F" sort="Leckman, James F" uniqKey="Leckman J" first="James F." last="Leckman">James F. Leckman</name><affiliation><nlm:aff id="aff6"></nlm:aff></affiliation></author><author><name sortKey="Nielsen, Helena Skyt" sort="Nielsen, Helena Skyt" uniqKey="Nielsen H" first="Helena Skyt" last="Nielsen">Helena Skyt Nielsen</name><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author><author><name sortKey="Simonsen, Marianne" sort="Simonsen, Marianne" uniqKey="Simonsen M" first="Marianne" last="Simonsen">Marianne Simonsen</name><affiliation><nlm:aff id="aff5"></nlm:aff></affiliation></author></analytic><series><title level="j">Journal of Child and Adolescent Psychopharmacology</title><idno type="ISSN">1044-5463</idno><idno type="eISSN">1557-8992</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><p><bold><italic>Objective:</italic></bold> The purpose of this study was to determine whether stimulant users are at higher risk of a later cardiovascular event than are non-users, examining this association in both a national cohort and a population-based sample of children and adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD). We also aim to examine a possible dose-response relationship in such an association.</p><p><bold><italic>Methods:</italic></bold> We conducted a longitudinal, prospective cohort study of all children born in Denmark between 1990 and 1999. Within this cohort, children with ADHD were identified. Data from national health registers on psychiatric and somatic diagnoses, stimulant prescriptions, cardiovascular risk factors, pre- and perinatal and sociodemographic covariates in all children and their parents were merged, using the unique personal identification number. Hazard ratios (HR) for cardiovascular events were estimated using Cox regression, adjusted for other known risk factors.</p><p><bold><italic>Results:</italic></bold> In the total population (<italic>n</italic>=714,258 contributing a total of 6,767,982 person-years) use of stimulants increased the risk of a cardiovascular event; adjusted HR=1.83 (1.10–3.04). In children with ADHD (<italic>n</italic>=8300) stimulant treatment also increased the risk of a cardiovascular event (adjusted HR=2.20 [2.15–2.24]), with a complex time-dependent dose-response relationship.</p><p><bold><italic>Conclusions:</italic></bold> This is the first nationwide cohort study of the cardiovascular safety of stimulants in children and adolescents, and it represents, to our knowledge, the longest prospective follow-up study. Cardiovascular events were rare but twice as likely in stimulant users as in non-users, both in the total national population and in children with ADHD. We found a complex, time- and dose-dependent interrelationship between cardiovascular adverse events and stimulant treatment in children and adolescents. Our results suggest a safety signal with an increased risk of cardiovascular disease associated with stimulant treatment in children and adolescents, even after adjusting for a number of potential confounders.</p></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">J Child Adolesc Psychopharmacol</journal-id><journal-id journal-id-type="iso-abbrev">J Child Adolesc Psychopharmacol</journal-id><journal-id journal-id-type="publisher-id">cap</journal-id><journal-title-group><journal-title>Journal of Child and Adolescent Psychopharmacology</journal-title></journal-title-group><issn pub-type="ppub">1044-5463</issn><issn pub-type="epub">1557-8992</issn><publisher><publisher-name>Mary Ann Liebert, Inc.</publisher-name><publisher-loc>140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">24956171</article-id><article-id pub-id-type="pmc">4137345</article-id><article-id pub-id-type="publisher-id">10.1089/cap.2014.0020</article-id><article-id pub-id-type="doi">10.1089/cap.2014.0020</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Cardiovascular Safety of Stimulants in Children with Attention-Deficit/Hyperactivity Disorder: A Nationwide Prospective Cohort Study</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Dalsgaard</surname><given-names>Søren</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="aff1"><sup>1,</sup></xref><xref ref-type="aff" rid="aff2"><sup>2,</sup></xref><xref ref-type="aff" rid="aff3"><sup>3,</sup></xref><xref ref-type="aff" rid="aff4"><sup>4</sup></xref></contrib><contrib contrib-type="author"><name><surname>Kvist</surname><given-names>Anette Primdal</given-names></name><degrees>MSc</degrees><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Leckman</surname><given-names>James F.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="aff6"><sup>6</sup></xref></contrib><contrib contrib-type="author"><name><surname>Nielsen</surname><given-names>Helena Skyt</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><contrib contrib-type="author"><name><surname>Simonsen</surname><given-names>Marianne</given-names></name><degrees>PhD</degrees><xref ref-type="aff" rid="aff5"><sup>5</sup></xref></contrib><aff id="aff1"><label><sup>1</sup></label>National Centre for Register-based Research, School of Business and Social Sciences, Department of Economics and Business,<institution>Aarhus University</institution>, Aarhus,<country>Denmark</country>.</aff><aff id="aff2"><label><sup>2</sup></label><institution>The Lundbeck Foundation Initiative for Integrative Psychiatric Research</institution>,<italic>i</italic>PSYCH, Aarhus and Copenhagen,<country>Denmark</country>.</aff><aff id="aff3"><label><sup>3</sup></label>Department of Child and Adolescent Psychiatry,<institution>Hospital of Telemark</institution>, Kragerø,<country>Norway</country>.</aff><aff id="aff4"><label><sup>4</sup></label>Department of Child and Adolescent Mental Health Odense, Research Unit, Mental Health Services in the Region of Southern Denmark,<institution>University of Southern Denmark</institution>,<country>Denmark</country>.</aff><aff id="aff5"><label><sup>5</sup></label>Department of Economics and Business,<institution>Aarhus University</institution>, Aarhus,<country>Denmark</country>.</aff><aff id="aff6"><label><sup>6</sup></label>Child Study Center,<institution>Yale University School of Medicine</institution>, New Haven, Connecticut.</aff></contrib-group><author-notes><corresp id="fn1"><bold>Funding:</bold> The study was funded by grants from the Lundbeck Foundation, the Danish Council for Independent Research (Sapere Aude Starting Grant, 10-079597), Centre For Integrated Register-Based Research at Aarhus University (CIRRAU), The Foundation for Psychiatric Research in the Region of Southern Denmark, and Slagtermester Max Wørzner and Inger Wørzners Foundation.</corresp><corresp><addr-line>Address correspondence to:</addr-line><addr-line><italic>Søren Dalsgaard, MD, PhD</italic></addr-line><addr-line><italic>National Centre for Register-Based Research</italic></addr-line><institution><italic>Aarhus University</italic></institution><addr-line><italic>Fuglesangs Allé 4, Building K</italic></addr-line><addr-line><italic>8210 Aarhus V</italic></addr-line><country>Denmark</country><break></break><italic>E-mail:</italic><email xlink:href="mailto:sdalsgaard@ncrr.dk">sdalsgaard@ncrr.dk</email></corresp></author-notes><pub-date pub-type="ppub"><day>01</day><month>8</month><year>2014</year><pmc-comment>string-date: August 2014</pmc-comment>
</pub-date><volume>24</volume><issue>6</issue><fpage>302</fpage><lpage>310</lpage><permissions><copyright-statement>Copyright 2014, Mary Ann Liebert, Inc.</copyright-statement><copyright-year>2014</copyright-year></permissions><self-uri content-type="pdf" xlink:type="simple" xlink:href="cap.2014.0020.pdf"></self-uri><abstract><title>Abstract</title><p><bold><italic>Objective:</italic></bold> The purpose of this study was to determine whether stimulant users are at higher risk of a later cardiovascular event than are non-users, examining this association in both a national cohort and a population-based sample of children and adolescents diagnosed with attention-deficit/hyperactivity disorder (ADHD). We also aim to examine a possible dose-response relationship in such an association.</p><p><bold><italic>Methods:</italic></bold> We conducted a longitudinal, prospective cohort study of all children born in Denmark between 1990 and 1999. Within this cohort, children with ADHD were identified. Data from national health registers on psychiatric and somatic diagnoses, stimulant prescriptions, cardiovascular risk factors, pre- and perinatal and sociodemographic covariates in all children and their parents were merged, using the unique personal identification number. Hazard ratios (HR) for cardiovascular events were estimated using Cox regression, adjusted for other known risk factors.</p><p><bold><italic>Results:</italic></bold> In the total population (<italic>n</italic>=714,258 contributing a total of 6,767,982 person-years) use of stimulants increased the risk of a cardiovascular event; adjusted HR=1.83 (1.10–3.04). In children with ADHD (<italic>n</italic>=8300) stimulant treatment also increased the risk of a cardiovascular event (adjusted HR=2.20 [2.15–2.24]), with a complex time-dependent dose-response relationship.</p><p><bold><italic>Conclusions:</italic></bold> This is the first nationwide cohort study of the cardiovascular safety of stimulants in children and adolescents, and it represents, to our knowledge, the longest prospective follow-up study. Cardiovascular events were rare but twice as likely in stimulant users as in non-users, both in the total national population and in children with ADHD. We found a complex, time- and dose-dependent interrelationship between cardiovascular adverse events and stimulant treatment in children and adolescents. Our results suggest a safety signal with an increased risk of cardiovascular disease associated with stimulant treatment in children and adolescents, even after adjusting for a number of potential confounders.</p></abstract><counts><table-count count="4"></table-count><ref-count count="48"></ref-count><page-count count="9"></page-count></counts></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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