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Determinants of severe QT c prolongation in a real-world gerontopsychiatric setting
Ist Teil von
Frontiers in psychiatry, 2023, Vol.14, p.1157996
Ort / Verlag
Switzerland
Erscheinungsjahr
2023
Link zum Volltext
Quelle
EZB Free E-Journals
Beschreibungen/Notizen
QT
prolongation carries the risk of ventricular tachyarrhythmia (Torsades de Pointes) and sudden cardiac death. Psychotropic drugs can affect ventricular repolarization and thus prolong the QT
interval. The present study sought to investigate the risk factors (pharmacological and non-pharmacological) of severe QT
prolongation in gerontopsychiatric patients.
Electrocardiograms of patients on a gerontopsychiatric ward were screened for QT
prolongation. Medication lists were examined utilizing the AzCERT classification. Potential drug interactions were identified with the electronic drug interaction program mediQ.
The overall prevalence of QT
prolongation was 13.6%, with 1.9% displaying severe QT
prolongation (≥ 500 ms). No statistically significant differences between patients with moderate and severe QT
prolongation were identified; however, patients with severe QT
prolongation tended to take more drugs (
= 0.063). 92.7% of patients with QT
prolongation took at least one AzCERT-listed drug, most frequently risperidone and pantoprazole. Risperidone and pantoprazole, along with pipamperone, were also most frequently involved in potential drug interactions. All patients displayed additional risk factors for QT
prolongation, particularly cardiac diseases.
In addition to the use of potentially QT
-prolonging drugs, other risk factors, especially cardiac diseases, appear to be relevant for the development of QT
prolongation in gerontopsychiatric patients. Pantoprazole was frequently involved in potential drug interactions and should generally not be used for more than 8 weeks in geriatric populations. As clinical consequences of QT
prolongation were rare, potentially QT
-prolonging drugs should not be used overcautiously; their therapeutic benefit should be considered as well. It is paramount to perform diligent benefit-risk analyses prior to the initiation of potentially QT
-prolonging drugs and to closely monitor their clinical (side) effects.
Sprache
Englisch
Identifikatoren
ISSN: 1664-0640
eISSN: 1664-0640
Titel-ID: cdi_pubmed_primary_37032947
Format
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