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July 10, 2017Journal of Evaluation in Clinical PracticeOpen Access

Risk factors, particularly history of prolonged QTc interval (39 ms) and female sex (12 ms), were associated with greater QTc lengthening than any QTc-prolonging medication category alone.

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Why the study?

Do QTc interval-prolonging medications and clinical risk factors increase QTc interval lengthening in a community cohort?

Population

14,160 participants from the Atherosclerosis Risk in Communities study with a resting, standard 12-lead…

Comparison

QTc interval-prolonging medications categorized… vs Absence of QTPMs or absence of risk factors

Design

Cohort

Follow-up

4 examinations at 3-year intervals (1987-1998)

Key result

Risk factors, particularly history of prolonged QTc interval (39 ms) and female sex (12 ms), were associated with greater QTc lengthening than any QTc-prolonging medication category alone.

Authors

KAKhalid A. AlburikanAAAhmed AldemerdashSSSamuel T. Savitz

Discussion

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Overview

Risk factors like prior prolonged QTc may warrant prioritized monitoring over medication review alone; leaves open causal effects after adjustment.

Study Design

Type

Cohort (n=15,792)

Multicenter

Yes

Structured PICO

Do QTc interval-prolonging medications and clinical risk factors increase QTc interval lengthening in a community cohort?

P
Population
14,160 participants from the Atherosclerosis Risk in Communities (ARIC) study with a resting, standard 12-lead electrocardiogram and ≥1 measure of QTc interval over 4 examinations. Excluded participants with QRS ≥ 120 milliseconds.
I
Intervention
QTc interval-prolonging medications (QTPMs) categorized by CredibleMeds (Known, Possible, or Conditional risk) and clinical risk factors (age ≥ 65 years, female sex, left ventricular hypertrophy, QTc > 500 milliseconds at prior visit)
C
Comparator
Absence of QTPMs or absence of risk factors
O
Outcome
Magnitude of QTc interval lengtheningsurrogate

Clinical risk factors, particularly female sex and history of prolonged QTc, have stronger associations with QTc lengthening than QTc-prolonging medications alone, though medications further augment this risk.

Cite This Study

Alburikan et al. (2017) conducted a cohort in QTc interval lengthening (n=15,792). QTc interval-prolonging medications (QTPMs) and risk factors vs. Absence of QTPMs or risk factors was evaluated on QTc interval lengthening. Risk factors, particularly history of prolonged QTc interval (39 ms) and female sex (12 ms), were associated with greater QTc lengthening than any QTc-prolonging medication category alone.

synapsesocial.com/papers/6a131335b761793c20c1143chttps://doi.org/10.1111/jep.12776
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