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Association between methylphenidate and risk of myocardial infarction: a multinational self-controlled case series study

Jeong, HE; Lee, H; Lai, ECC; Liao, TC; Man, K; Wong, ICK; Coghill, D; ... Shin, JY; + view all (2021) Association between methylphenidate and risk of myocardial infarction: a multinational self-controlled case series study. Pharmacoepidemiology and Drug Safety , 30 (10) pp. 1458-1467. 10.1002/pds.5322. Green open access

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Abstract

Purpose: To investigate the association between use of methylphenidate and risk of myocardial infarction among Asians. // Methods: We conducted a multinational self-controlled case series study using nationwide healthcare databases of South Korea (2002–2018), Taiwan (2004–2015), and Hong Kong (2001–2016). Of patients with myocardial infarction who were also prescribed methylphenidate within the observation period, methylphenidate use was classified into four mutually exclusive periods by each person-day: exposed (exposed to methylphenidate), pre-exposure (prior to the first methylphenidate prescription), washout (after the end of methylphenidate treatment), and baseline (unexposed to methylphenidate). Risk of myocardial infarction among the three periods of methylphenidate use was compared to the baseline period using conditional Poisson regression analysis to estimate incidence rate ratios (IRRs) with 95% confidence intervals (CIs). // Results: We identified 2104, 484, and 30 patients from South Korea, Taiwan, and Hong Kong, respectively. Risk of myocardial infarction was the highest during the pre-exposure period in all three populations: South Korea, pre-exposure (IRR 3.17, 95% CI 3.04–3.32), exposed (1.05, 1.00–1.11), washout (1.92, 1.80–2.04); Taiwan, pre-exposure (1.97, 1.78–2.17), exposed (0.72, 0.65–0.80), washout (0.56, 0.46–0.68); Hong Kong, pre-exposure (18.09, 8.19–39.96), exposed (9.32, 3.44–25.28), washout (7.69, 1.72–34.41). Following stratification for age and sex, the trends remained analogous to the main findings across all three populations. // Conclusions: Although a positive association between initiating methylphenidate and the onset of myocardial infarction was observed, the risk was the highest in the period before its initiation. Thus, this multinational study suggests there was no causal relationship between methylphenidate and myocardial infarction among Asians.

Type: Article
Title: Association between methylphenidate and risk of myocardial infarction: a multinational self-controlled case series study
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/pds.5322
Publisher version: https://doi.org/10.1002/pds.5322
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > UCL School of Pharmacy > Practice and Policy
URI: https://discovery.ucl.ac.uk/id/eprint/10130705
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