OBJECTIVE To identify characteristics associated with an increased risk of cardiovascular events in patients diagnosed with Alzheimer disease (AD) and treated with antidementia medications. METHODS Demographics, diagnoses, and medication usage of 30 433 Medicare patients were analyzed using 2006 to 2013 claims data and a combined model of screening, ranking and stepwise logistic regressions to evaluate factors associated with composite outcomes of 6 cardiovascular events. RESULTS Incidence rate of at least 1 cardiovascular event was 25.1%. Fifty-five factors were identified from the 10 381 candidate variables by the combined model with a c-statistic of 67% and an accuracy of 75%. Factors associated with increased risk of cardiovascular events include history of heart rhythm disorders, alteration of consciousness (odds ratio [OR]: 1.25; 95% confidence interval [CI]: 1.14-1.36), and usage of β-blockers (OR: 1.19; 95% CI: 1.13-1.27). CONCLUSIONS Clinicians should consider the increased risk of cardiovascular events in patients with AD with heart rhythm disorders and on β-blockers.

中文翻译：

---

服用抗痴呆药物的患者发生心血管事件的危险因素。


目的 确定诊断为阿尔茨海默病 (AD) 并接受抗痴呆药物治疗的患者中与心血管事件风险增加相关的特征。方法 使用 2006 年至 2013 年索赔数据以及筛选、排名和逐步逻辑回归的组合模型对 30 433 名医疗保险患者的人口统计、诊断和药物使用情况进行分析，以评估与 6 种心血管事件的复合结果相关的因素。结果至少1次心血管事件的发生率为25.1%。组合模型从 10 381 个候选变量中识别出 55 个因子，c 统计量为 67%，准确度为 75%。与心血管事件风险增加相关的因素包括心律失常病史、意识改变（比值比 [OR]：1.25；95% 置信区间 [CI]：1.14-1.36）以及使用 β 受体阻滞剂（OR：1.19） ; 95% CI: 1.13-1.27)。结论 临床医生应考虑患有心律失常且服用 β 受体阻滞剂的 AD 患者心血管事件的风险增加。