Hospital Pharmacist, Medical Center Alkmaar, Department of Clinical Pharmacy, Wilhelminalaan 12, Alkmaar 1815 JD, the Netherlands
J Clin Psychiatry. 2014 Jan;75(1):15-21. doi: 10.4088/JCP.13m08397.
To investigate the association between the use of a selective serotonin reuptake inhibitor (SSRI) and the occurrence of QT interval prolongation in an elderly surgical population.
A cross-sectional study was conducted among patients (> 60 years) scheduled for outpatient preanesthesia evaluation in the period 2007 until 2012. The index group included elderly users of an SSRI. The reference group of nonusers of antidepressants was matched to the index group on sex and year of scheduled surgery (ratio, 1:1). The primary outcome was the occurrence of QT interval prolongation shown on electrocardiogram. The QT interval was corrected for heart rate (QTc interval). The secondary outcome was the duration of the QTc interval. The outcomes were adjusted for confounding by using regression techniques.
The index and reference groups included 397 users of an SSRI and 397 nonusers, respectively. QTc interval prolongation occurred in 25 (6%) and 19 (5%) index and reference patients, respectively. After adjustment for confounding, users of an SSRI did not have a higher risk for QTc interval prolongation compared to nonusers: OR = 1.1 (95% CI, 0.5 to 2.0). The adjusted mean QTc interval length in users of an SSRI and nonusers was comparable (difference of 1.5 milliseconds [95% CI, -1.8 to 4.8]). Use of the most frequently used SSRIs citalopram and paroxetine was not associated with a higher risk of QTc interval prolongation nor with lengthening of the QTc interval duration.
The use of an SSRI by elderly surgical patients was not associated with the occurrence of QT interval prolongation.
调查选择性 5-羟色胺再摄取抑制剂（SSRI）的使用与老年手术人群 QT 间期延长的发生之间的关系。
对 2007 年至 2012 年期间接受门诊术前评估的患者（>60 岁）进行了一项横断面研究。指数组包括使用 SSRI 的老年患者。非抗抑郁药使用者的参考组与指数组按性别和手术年份（比例为 1:1）相匹配。主要结局是心电图显示 QT 间期延长。QT 间期通过心率校正（QTc 间期）。次要结局是 QTc 间期的持续时间。使用回归技术调整混杂因素对结果进行调整。
指数组和参考组分别包括 397 例 SSRI 使用者和 397 例非使用者。指数和参考组患者中分别有 25 例（6%）和 19 例（5%）出现 QTc 间期延长。调整混杂因素后，SSRI 使用者与非使用者相比，QTc 间期延长的风险没有更高：OR=1.1（95%CI，0.5 至 2.0）。SSRI 使用者和非使用者的校正平均 QTc 间期长度相当（差异为 1.5 毫秒[95%CI，-1.8 至 4.8]）。最常使用的 SSRI 西酞普兰和帕罗西汀的使用与 QTc 间期延长或 QTc 间期持续时间延长的风险增加无关。
老年手术患者使用 SSRI 与 QT 间期延长的发生无关。
