Epilepsy is a chronic disease that requires long-term monitoring and treatment. It is suspected that there is a interaction between the use of anti-seizure medications and the risk of cardiovascular disease. The aim of the study is to investigate the association between the intake of phenobarbital, carbamazepine and valproic acid and their serum drug concentrations (SDC) with various cardiovascular risk parameters (homocysteine, folic acid, vitamin B12, total cholesterol (TC), triglycerides, high- and low-density lipoprotein (LDL)). This is a cross-sectional study. Data (demographic characteristics and laboratory results) of patients treated for epilepsy in a tertiary care hospital between January 2020 and February 2022 were analyzed retrospectively (n = 2014). Kruskal Wallis, Mann-Whitney U, correlation analysis was used, p < 0.05 was considered statistically significant. The median age of patients was 15 years (IQR:8–31) and 48.3 % were women. The highest homocysteine level was found in patients receiving valproic acid, but it was not statistically significant. Patients receiving phenobarbital had the highest levels of folic acid and B12 and the lowest levels of total cholesterol and low-density lipoprotein cholesterol, which was statistically significant. In patients receiving carbamazepine, a moderately negative significant association was found between serum drug concentration and folic acid levels and a moderately positive significant association was found between TC and LDL levels. In our study, the majority of patients were children and adolescents. Regular monitoring of drug serum concentrations and metabolic parameters may be useful to select the safest drug in terms of cardiovascular disease risk. Randomized controlled trials on the long-term effects of anti-seizure treatment are needed.

中文翻译：

---

抗癫痫药物及其血清浓度与心血管风险参数的评估：横断面研究

癫痫是一种慢性疾病，需要长期监测和治疗。人们怀疑抗癫痫药物的使用与心血管疾病的风险之间存在相互作用。该研究的目的是调查苯巴比妥、卡马西平和丙戊酸的摄入量及其血清药物浓度 (SDC) 与各种心血管风险参数（同型半胱氨酸、叶酸、维生素 B12、总胆固醇 (TC)、甘油三酯、高密度脂蛋白和低密度脂蛋白（LDL））。这是一项横断面研究。对 2020 年 1 月至 2022 年 2 月期间在三级甲等医院接受癫痫治疗的患者的数据（人口统计学特征和实验室结果）进行回顾性分析（n = 2014）。 Kruskal Wallis, Mann-Whitney U，使用相关分析，p < 0.05 被认为有统计学意义。患者的中位年龄为 15 岁（IQR：8-31），其中 48.3% 为女性。接受丙戊酸治疗的患者同型半胱氨酸水平最高，但没有统计学意义。接受苯巴比妥治疗的患者叶酸和维生素B12水平最高，总胆固醇和低密度脂蛋白胆固醇水平最低，具有统计学意义。在接受卡马西平的患者中，血清药物浓度和叶酸水平之间存在中度负显着相关性，TC 和 LDL 水平之间存在中度显着正相关关系。在我们的研究中，大多数患者是儿童和青少年。定期监测药物血清浓度和代谢参数可能有助于选择心血管疾病风险方面最安全的药物。需要对抗癫痫治疗的长期效果进行随机对照试验。