Drug-Induced QTc Interval Prolongation: A Multicenter Study to Detect Drugs and Clinical Factors Involved in Every Day Practice

Author(s): Guillermo A. Keller , Paulino A. Alvarez , Marcelo L. Ponte , Waldo H. Belloso , Claudia Bagnes , Cecilia Sparanochia , Claudio D. Gonzalez , M. Cecilia Villa Etchegoyen , Roberto A. Diez , Guillermo Di Girolamo .

Journal Name: Current Drug Safety

Volume 11 , Issue 1 , 2016

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Abstract:

Objective: The actual prevalence of drug induced QTc prolongation in clinical practice is unknown. Our objective was to determine the occurrence and characteristics of drug-induced QT prolongation in several common clinical practices. Additionally, a subgroup of patients treated with dextropropoxyphene of particular interest for the regulatory authority was analysed.

Research Design and Methods: Medical history and comorbidities predisposing to QT interval prolongation were registered for 1270 patient requiring medical assistance that involved drug administration. Three ionograms and ECGs were performed: baseline, intra- and after treatment; QT interval was corrected with Bazzet formula.

Results: Among patients, 9.9% presented QTc >450/470 ms, 3% QTc > 500 ms, 12.7% ΔQTc >30 ms and 5.2% ΔQTc >60 ms. QTc prolongation associated with congestive heart failure, ischemic cardiopathy, diabetes, renal failure, arrhythmias, hypothyroidism, and bradycardia. At univariate analysis, clarithromycin, haloperidol, tramadol, amiodarone, glyceryl trinitrate, amoxicillin + clavulanic acid, amoxicillin + sulbactam, ampicillin + sulbactam, fentanyl, piperacillin + tazobactam, and diazepam prolonged QTc. Prolongation remained significantly associated with furosemide, clarithromycin, glyceryl trinitrate and betalactamase inhibitors after multivariate analysis.

Conclusion: QT interval prolongation in everyday practice is frequent, in association to clinical factors and drugs that can be easily identified for monitoring and prevention strategies.

Keywords: Adverse drug reaction, QT-Interval prolongation, torsade des Pointes, arrhythmia.

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Article Details

VOLUME: 11
ISSUE: 1
Year: 2016
Page: [86 - 98]
Pages: 13
DOI: 10.2174/1574886311207040262

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