E-DRUG: Non-cardiac QTc-prolonging drugs and sudden cardiac death
------------------------------------------------------------
[The abstract and additional information are included below. BS]
E-Drug subscribers may wish to read the following abstract of an article
as posted in the European Heart Journal Advance Access published online
on May 11, 2005. The article suggests that the use of non-cardiac
QTc-prolonging drugs is associated with an increased risk of sudden
cardiac death.
The URL to the abstract is :
http://eurheartj.oupjournals.org/cgi/content/abstract/ehi312v1?eaf
<http://eurheartj.oupjournals.org/cgi/content/abstract/ehi312v1?eaf>
With best wishes,
Shanthi Pal, M.Pharm PhD
Quality Assurance and Safety: Medicines
Department of Medicines Policy and Standards
World Health Organization
Geneva, Switzerland
Tel: + 41 22 791 1318
E-mail: pals@who.int
Website: http://www.who.int/medicines
------------------------------------------------------------------------
Clinical research
Non-cardiac QTc-prolonging drugs and the risk of sudden cardiac death
Sabine M.J.M. Straus, Miriam C.J.M. Sturkenboom et al.
Aims To assess the association between the use of non-cardiac
QTc-prolonging drugs and the risk of sudden cardiac death.
Methods and results A population-based case-control study was performed
in the Integrated Primary Care Information (IPCI) project, a
longitudinal observational database with complete medical records from
more than 500 000 persons. All deaths between 1 January 1995 and 1
September 2003 were reviewed. Sudden cardiac death was classified based
on the time between onset of cardiovascular symptoms and death. For each
case, up to 10 random controls were matched for age, gender, date of
sudden death, and general practice. The exposure of interest was the use
of non-cardiac QTc-prolonging drugs. Exposure at the index date was
categorized into three mutually exclusive groups of current use, past
use, and non-use. The study population comprised 775 cases of sudden
cardiac death and 6297 matched controls. Current use of any non-cardiac
QTc-prolonging drug was associated with a significantly increased risk
of sudden cardiac death (adjusted OR: 2.7; 95% CI: 1.6-4.7). The risk of
death was highest in women and in recent starters.
Conclusion The use of non-cardiac QTc-prolonging drugs in a general
population is associated with an increased risk of sudden cardiac death.
-------------------------------------------------------------
Nicola Pocock
Author affiliation
Hospital Pharmacist
Source
European Heart Journal Advance Access published online on May 11, 2005
Resource Links
Link (subscribers only)
Abstract
Results from a population-based case-control study published in the European Heart Journal Advance Access online suggest that the use of non-cardiac QTc-prolonging drugs is associated with an increased risk of sudden cardiac death.
The researchers reviewed all deaths between 1 January 1995 and 1 September 2003 taken from a longitudinal observational database with complete medical records from over 500,000 people. Sudden cardiac death was classified based on the time between onset of cardiovascular symptoms and death. For each case, up to 10 random controls were matched for age, gender, date of sudden death, and general practice. The exposure of interest was the use of non-cardiac QTc-prolonging drugs, comprising chloroquine, chlorpromazine, cisapride, clarithromycin, domperidone, droperidol, erythromycin, halofrantine, haloperidol, levomethadyl, mesoridazine, pentamidine, pimozide, sparfloxacin and thioridazine. Exposure at the index date was categorised into three mutually exclusive groups of current use, past use, and non-use.
The study population comprised 775 cases of sudden cardiac death and 6,297 matched controls. Current use of any non-cardiac QTc-prolonging drug was associated with a significantly increased risk of sudden cardiac death (adjusted OR: 2.7; 95% CI: 1.6-4.7). The risk of death was highest in women and in recent starters.