急性药物过量时QT间期延长的种族易感性。
Racial susceptibility for QT prolongation in acute drug overdoses.
作者信息
Manini Alex F, Stimmel Barry, Vlahov David
机构信息
Division of Medical Toxicology, the Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Cardiology Division, the Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
J Electrocardiol. 2014 Mar-Apr;47(2):244-50. doi: 10.1016/j.jelectrocard.2013.12.002. Epub 2013 Dec 4.
BACKGROUND AND PURPOSE
QT prolongation independently predicts adverse cardiovascular events in suspected poisoning. We aimed to evaluate the association between race and drug-induced QT prolongation for patients with acute overdose.
METHODS
This was a cross-sectional observational study at two urban teaching hospitals. Consecutive adult ED patients with acute drug overdose were prospectively enrolled over a two year period. The primary outcome, long-QT, was defined using standard criteria: QTc>470 ms in females and>460 ms in males. The association between race and drug-induced QT prolongation was tested, considering several confounding variables.
RESULTS
In 472 patients analyzed (46% female, mean age 42.3), QT prolongation occurred in 12.7%. Blacks had two-fold increased odds of drug-induced QT prolongation (OR 2.01, CI 1.03-3.91) and Hispanics had 48% decreased odds of drug-induced QT prolongation (OR 0.52, CI 0.29-0.94).
CONCLUSIONS
We found significant racial susceptibility to drug-induced QT prolongation in this large urban study of acute overdoses.
背景与目的
QT间期延长可独立预测疑似中毒患者发生不良心血管事件。我们旨在评估急性药物过量患者的种族与药物诱导的QT间期延长之间的关联。
方法
这是一项在两家城市教学医院开展的横断面观察性研究。在两年时间里，前瞻性纳入连续的成年急诊患者，这些患者均有急性药物过量情况。主要结局指标“长QT”采用标准标准定义：女性QTc>470毫秒，男性QTc>460毫秒。在考虑多个混杂变量的情况下，对种族与药物诱导的QT间期延长之间的关联进行了检验。
结果
在分析的472例患者中（46%为女性，平均年龄42.3岁），QT间期延长的发生率为12.7%。黑人发生药物诱导的QT间期延长的几率增加了两倍（比值比2.01，可信区间1.03 - 3.91），西班牙裔发生药物诱导的QT间期延长的几率降低了48%（比值比0.52，可信区间0.29 - 0.94）。
结论
在这项针对急性药物过量的大型城市研究中，我们发现不同种族对药物诱导的QT间期延长存在显著易感性。
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