Kurniawan Theresia G, Setiawati Arini, Makmun Lukman H
Department of Pharmacology, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
Acta Med Indones. 2014 Oct;46(4):292-7.
To evaluate the incidence of QTc interval prolongation associated with the use of amiodarone, as well as factors that influence its occurrence.
This was a descriptive retrospective study conducted from November 2010 until December 2011 using medical record of patients at ICCU Cipto Mangunkusumo Hospital from 2004-2011. Four groups of patients were included: (1) patients receiving amiodarone and other drugs causing which can cause QTc prolongation, (2) patients receiving amiodarone and other drug not causing QTc prolongation, (3) patients receiving drugs which can cause causing QTc prolongation, (4) patients not receiving amiodarone, nor other drugs which can cause causing QTc prolongation (served as control group). Difference of QTc interval within the same group was analyzed with paired t-test or Wilcoxon matched-pairs test. Between groups comparison were performed with Kruskal Wallis test. The influence of other factors (sex, age, heart failure, liver disorder, electrolyte imbalance) on QTc prolongation was analyzed using multiple regression.
QTc interval prolongation in groups 1, 2, and 3 were respectively 65.5%, 63.3%, 56.6%, which were significantly different from control group (24.4%); Hypernatremia and hypertension were revealed as significant risk factor for QTc prolongation. Mortality occurred in 3, 4, and 4 patients in group 1, 2, and 3 respectively, and none in group 4.
QTc interval prolongation occurred in association with amiodarone and other drugs known to prolong QTc interval. Hypernatremia and hypertension were shown as significant influencing factor of QTc interval prolongation.
评估与使用胺碘酮相关的QTc间期延长的发生率,以及影响其发生的因素。
这是一项描述性回顾性研究,于2010年11月至2011年12月进行,使用了2004 - 2011年雅加达中央医院心脏重症监护病房(ICCU Cipto Mangunkusumo Hospital)患者的病历。纳入四组患者:(1)接受胺碘酮及其他可导致QTc延长的药物的患者;(2)接受胺碘酮及其他不导致QTc延长的药物的患者;(3)接受可导致QTc延长的药物的患者;(4)未接受胺碘酮及其他可导致QTc延长的药物的患者(作为对照组)。同一组内QTc间期的差异采用配对t检验或Wilcoxon配对检验进行分析。组间比较采用Kruskal Wallis检验。使用多元回归分析其他因素(性别、年龄、心力衰竭、肝脏疾病、电解质失衡)对QTc延长的影响。
第1、2、3组的QTc间期延长分别为65.5%、63.3%、56.6%,与对照组(24.4%)有显著差异;高钠血症和高血压被揭示为QTc延长的显著危险因素。第1、2、3组分别有3例、4例和4例患者死亡,第4组无死亡病例。
QTc间期延长与胺碘酮及其他已知可延长QTc间期的药物有关。高钠血症和高血压被证明是QTc间期延长的重要影响因素。