# \[e-drug\] Non-cardiac QTc-prolonging drugs and sudden cardiac death

**URL:** <https://talk.edrugplus.org/t/e-drug-non-cardiac-qtc-prolonging-drugs-and-sudden-cardiac-death/22454>\
**Category:** e-drug\
**Created:** [May 12, 2005, 7:48am UTC](https://talk.edrugplus.org/t/e-drug-non-cardiac-qtc-prolonging-drugs-and-sudden-cardiac-death/22454 "2005-05-12T07:48:55Z")\
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**Author:** ![pals](https://avatars.discourse-cdn.com/v4/letter/p/9fc348/32.png) [@pals](https://talk.edrugplus.org/u/pals)\
**Post date:** [May 12, 2005, 7:48am UTC](https://talk.edrugplus.org/t/e-drug-non-cardiac-qtc-prolonging-drugs-and-sudden-cardiac-death/22454/1 "2005-05-12T07:48:55Z")

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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)  
\<[http://eurheartj.oupjournals.org/cgi/content/abstract/ehi312v1?eaf&gt](http://eurheartj.oupjournals.org/cgi/content/abstract/ehi312v1?eaf&gt);

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](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.