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Drugs & Aging

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01-08-2014 | Original Research Article

Determinants of Torsades de Pointes in Older Patients with Drug-Associated Long QT Syndrome: A Case-Control Study

Authors: Sylvain Goutelle, Elodie Sidolle, Michel Ducher, Jacques Caron, Quadiri Timour, Patrice Nony, Aurore Gouraud

Published in: Drugs & Aging | Issue 8/2014

Abstract

Objective

Many elderly patients are routinely exposed to drugs that may prolong the cardiac QT interval and cause Torsades de pointes (TdP). However, predictors of TdP in patients with drug-associated long QT syndrome (LQTS) are not fully understood, especially in the geriatric population. The objective of this study was to identify risk factors of TdP in elderly patients with drug-associated LQTS.

Methods

In this retrospective, case-control study, documented reports of drug-associated LQTS plus TdP (n = 125) and LQTS without TdP (n = 81) in patients ≥65 years of age were retrieved from the French Pharmacovigilance Database over a 10-year period. Available clinical, biological, and drug therapy data were compared in the two groups and logistic regression was performed to identify significant predictors of TdP.

Results

The uncorrected QT interval was significantly longer in patients with TdP than in patients without TdP (577 ± 79 vs. 519 ± 68 ms; p = 0.0001). The number of drugs with a known risk of TdP administered to each patient was not a predictor of arrhythmia, nor was female gender. Logistic regression analysis identified the uncorrected QT interval as the only significant predictor of TdP. The receiver operating characteristic curve analysis was characterized by an area under the curve of 0.77 (95 % confidence interval 0.64–0.88) and a QT cutoff of 550 ms.

Conclusion

The uncorrected QT interval was significantly associated with the probability of TdP in elderly patients with acquired, drug-associated LQTS.

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Title: Determinants of Torsades de Pointes in Older Patients with Drug-Associated Long QT Syndrome: A Case-Control Study
Authors: Sylvain Goutelle
Elodie Sidolle
Michel Ducher
Jacques Caron
Quadiri Timour
Patrice Nony
Aurore Gouraud
Publication date: 01-08-2014
Publisher: Springer International Publishing
Published in: Drugs & Aging / Issue 8/2014
Print ISSN: 1170-229X
Electronic ISSN: 1179-1969
DOI: https://doi.org/10.1007/s40266-014-0188-y

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