Narcolepsy and risk of cardiovascular outcomes beyond stimulant use

After adjusting for stimulant use, this cohort study found that patients with narcolepsy experienced increased risk of developing cardiovascular disease compared with patients without narcolepsy. This finding suggests that patients with narcolepsy may benefit from routine screening and monitoring for cardiovascular events. Statement of Significance This study enhances our understanding of the association between narcolepsy and cardiovascular events by employing a robust causal inference framework and adjusting for medications used to manage narcolepsy symptoms, which are known to be associated with cardiovascular risk. The large population-based cohort study included 34 562 patients with narcolepsy and 100 405 propensity score-matched patients without narcolepsy. Patients with narcolepsy had an increased risk of developing cardiovascular events compared to without narcolepsy controls, even after adjusting for medication use, including stimulants. These findings highlight the importance of routine cardiovascular screening and monitoring for patients with narcolepsy to mitigate potential risks.