Key result
Heparin use with quinidine is linked to higher unbound quinidine and a ~13 ms longer RV ERP.
Why the study?
Pharmacodynamic and pharmacokinetic aspects relevant to the clinical application of unbound quinidine levels were not fully understood.
Does heparin administration or acute myocardial infarction alter unbound quinidine levels and its pharmacodynamic effects?
Comparison
Heparin administration vs no heparin in electrophysiologic testing patients; day 3 vs day 10 in acute myocardial infarction patients
Design
Observational cohort study
Follow-up
Up to 10 days for acute myocardial infarction patients
Authors
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May warrant caution with heparin-quinidine coadministration; leaves open clinical relevance for arrhythmia management.
Observational (n=31)
Does heparin administration or acute myocardial infarction alter unbound quinidine levels and its pharmacodynamic effects?
Absolute Event Rate: 279% vs 266%
p-value: p=<0.025
Unbound quinidine concentrations and pharmacokinetics are significantly altered by heparin administration and during acute myocardial infarction, highlighting the need for clinical context when interpreting these levels.
Kessler et al. (1989) conducted an observational in Patients receiving quinidine or with acute myocardial infarction (n=31). Heparin administration vs. Pre-administration and control patients was evaluated on Right ventricular effective refractory period (p=<0.025). Heparin administration in patients receiving quinidine significantly increased the right ventricular effective refractory period (266 vs 279; p<0.025) and unbound quinidine concentration.
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