Sudden cardiac arrest associated with use of a non-cardiac drug that reduces cardiac excitability: evidence from bench, bedside, and community
Key result
Nortriptyline use was associated with a significantly increased risk of sudden cardiac arrest in the general population (OR 4.5; 95% CI 1.1-19.5).
Why the study?
Does nortriptyline increase the risk of sudden cardiac arrest in the general population?
Population
944 victims of ECG-documented sudden cardiac arrest and 4354 matched controls in a prospective…
Comparison
Nortriptyline vs Matched controls without nortriptyline use
Design
Case-control
Authors
Discussion
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Implication
Nortriptyline may warrant caution in at-risk patients; this case-control association leaves open causality and should not yet change practice.
Study Design
Type
Case-Control (n=5,298)
Structured PICO
Does nortriptyline increase the risk of sudden cardiac arrest in the general population?
P
Population
944 victims of ECG-documented sudden cardiac arrest and 4,354 matched controls in a prospective community-based study.
E
Exposure
Nortriptyline
C
Comparator
Matched controls without nortriptyline use
O
Outcome
Sudden cardiac arrest (SCA)hard clinical
Main Result
Odds Ratio: 4.5 (95% CI 1.1–19.5)
Nortriptyline, a non-cardiac drug that impairs cardiac depolarization, is associated with a 4.5-fold increased risk of sudden cardiac arrest in the community.
Cite This Study
Bardai et al. (2013) conducted a case-control in Sudden cardiac arrest (n=5,298). Nortriptyline vs. Matched controls (non-use) was evaluated on Sudden cardiac arrest (OR 4.5, 95% CI 1.1-19.5). Nortriptyline use was associated with a significantly increased risk of sudden cardiac arrest in the general population (OR 4.5; 95% CI 1.1-19.5).