Department of Psychiatry, Inje University Haeundae Paik Hospital, Busan, Republic of Korea.
Department of Psychiatry, College of Medicine, Dong-A University, Busan, Republic of Korea.
Kaohsiung J Med Sci. 2020 Dec;36(12):1030-1037. doi: 10.1002/kjm2.12280. Epub 2020 Aug 9.
Although the association between antipsychotic use and corrected QT interval (QTc) prolongation has been repeatedly confirmed, the relationship has been rarely studied in a practical setting. Using data from the Research on Asian Psychotropic Prescription Patterns for Antipsychotics (REAP-AP) survey, our study aimed to investigate the prevalence and clinical correlates of QTc prolongation in 2553 Asian patients with schizophrenia. After adjusting for the potential effect of confounding factors, the baseline and clinical characteristics of the schizophrenia patients with and without QTc prolongation were compared using analyses of covariance and binary logistic analyses. In addition, a binary logistic analysis model with a forward selection method was used to identify the distinctive clinical correlates of QTc prolongation. QTc prolongation was noted in 1.1% of Asian patients with schizophrenia. Schizophrenia patients were characterized by lower proportions of disorganized speech and negative symptoms; higher use of amisulpride and clozapine; and higher proportions of rigidity, hypercholesterolemia, and sedation than those without QTc prolongation. Finally, a binary logistic mode showed that amisulpride, clozapine, rigidity, and hypercholesterolemia might be the distinctive clinical correlates of QTc prolongation in Asian patients with schizophrenia. These findings indicate the clinical implications that the uses of amisulpride and clozapine and the occurrences of rigidity and hypercholesterolemia may be potential risk factors for QTc prolongation of schizophrenia patients.
尽管抗精神病药物的使用与校正 QT 间期(QTc)延长之间的关联已被反复证实,但在实际环境中很少对其进行研究。本研究利用来自亚洲抗精神病药物处方模式研究(REAP-AP)的调查数据,旨在调查 2553 例亚洲精神分裂症患者中 QTc 延长的患病率和临床相关性。在调整潜在混杂因素的影响后,使用协方差分析和二元逻辑分析比较了 QTc 延长和未延长的精神分裂症患者的基线和临床特征。此外,还使用具有前向选择方法的二元逻辑分析模型来确定 QTc 延长的独特临床相关性。亚洲精神分裂症患者中有 1.1%存在 QTc 延长。与未发生 QTc 延长的患者相比,精神分裂症患者的特征为:言语紊乱和阴性症状比例较低;更常使用氨磺必利和氯氮平;出现僵硬、高胆固醇血症和镇静的比例更高。最后,二元逻辑模型显示,氨磺必利、氯氮平、僵硬和高胆固醇血症可能是亚洲精神分裂症患者 QTc 延长的独特临床相关性。这些发现表明,氨磺必利和氯氮平的使用以及僵硬和高胆固醇血症的发生可能是精神分裂症患者 QTc 延长的潜在危险因素。