Macrolides use and the risk of sudden cardiac death

Li, Xiang; Wang, Min; Liu, Guiyang; Zhou, Liang; Wang, Zhe; Li, Chuntong

doi:10.1080/14787210.2016.1179580

Cited by 5 publications

(5 citation statements)

References 33 publications

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“…Macrolide antibiotics are commonly used in the treatment of upper and lower respiratory infections and other sexually transmitted diseases. 46 Although considered generally free of adverse effects, including cardiovascular toxicity, several of the macrolide agents were recently reported to have arrhythmia-related cardiac effects. 47 A recent observational study showed that use of azithromycin was associated with a risk of death from cardiovascular causes that was 2 to 3 times higher than the risk associated with no use of antibiotics.…”

Section: Discussionmentioning

confidence: 99%

Magnitude of Coagulation Abnormalities and Associated Factors Among Patients with Heart Diseases at the University of Gondar Comprehensive Specialized Hospital

Aynalem¹,

Adane²,

Getawa³

2022

VHRM

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Background Heart disease is a leading cause of hospitalization, death, and poor physical function due to comorbid conditions such as atrial fibrillation and stroke. It affects the blood hemostatic system, vasculature, and flow dynamics, causing both arterial and venous thrombosis. Thus, this study aimed to determine the magnitude of coagulation abnormalities among patients with heart disease attending the University of Gondar Comprehensive Specialized hospital. Methods A cross-sectional study was conducted on a total of 98 patients with heart disease. Pretested structured questionnaires were used to collect data on socio-demographic and clinical variables. About 6 mL of venous blood was collected with the vacutainer method and analyzed using Huma cue-due plus and Sysmex KX-21N hematology analyzers for assessing coagulation abnormalities. Stool samples were processed via a direct wet mount. Thin and thick blood films were examined to assess malaria parasites. Data was entered into EPI-Info version 3.5.3 and then transported to SPSS version 20 for analysis. Descriptive statistics were summarized using frequency and percentage. Univariate and multivariate logistic regression models were fitted to identify factors associated with coagulopathy. P-value <0.05 was considered to be statistically significant. Results The overall magnitude of coagulation abnormalities (thrombocytopenia, prolonged prothrombin time, and activated partial thromboplastin time) in patients with heart diseases was 85.7% (95% CI: 81.96, 89.45). Besides, prolonged prothrombin time, prolonged activated partial thromboplastin time, and thrombocytopenia were detected in 83.7%, 33.7%, and 12.2% of the study participants, respectively. Participants who are taking medications for chronic disease (AOR = 0.17; 95% CI: 0.04, 0.69), participants with stroke (AOR = 20; 95% CI: 14.7, 35), and participants taking antibiotics (AOR = 8.17; 95% CI: 1.66, 40.27) were significantly associated with prolonged coagulation time. Conclusion This study showed that patients with heart disease had prolonged prothrombin time, activated partial thromboplastin time, and thrombocytopenia. Therefore, coagulation parameters are required to be checked regularly to monitor coagulation disorders and their complications in heart disease patients.

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Section: Discussionmentioning

confidence: 99%

Magnitude of Coagulation Abnormalities and Associated Factors Among Patients with Heart Diseases at the University of Gondar Comprehensive Specialized Hospital

Aynalem¹,

Adane²,

Getawa³

2022

VHRM

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“…Por exemplo, diversas classes de antibióticos são cardiotóxicas. [18][19][20] Neste cenário, compostos naturais têm sido cada vez mais estudados devido ao seu potencial na descoberta e no desenvolvimento de medicamentos. 36 Porém é importante também avaliar a segurança de compostos naturais utilizados para fins alimentares e médicos.…”

Section: Análise Estatísticaunclassified

“…17 Classicamente, como uma consequência de cardiotoxicidade, podem ser observadas alterações no eletrocardiograma (ECG), tais como o prolongamento do intervalo QT, o qual tem sido observado em pacientes que usaram várias classes de drogas antimicrobianas, incluindo macrólidos e fluoroquinolonas. [18][19][20] Entre os macrólidos, a administração intravenosa de eritromicina apresenta o risco maior de aumento do intervalo QT, e arritmias fatais têm sido relatadas quando foi usada isoladamente ou em combinação com outras drogas que prolongam o intervalo QT. 16 Portanto, a proteção da função cardíaca atualmente está um desafio constante para a indústria farmacêutica, autoridades reguladoras e médicos que enfrentam reações clínicas adversas de vários agentes terapêuticos na prática clínica.…”

Section: Introductionunclassified

Avaliação dos Efeitos Cardíacos de Lectina Solúvel em Água (WSMoL) de Sementes de Moringa Oleifera

et al. 2020

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ResumoFundsamento: As sementes de Moringa oleifera, que são utilizadas para clarificação de água, contêm uma lectina chamada WSMoL que tem mostrado atividade antibacteriana e imunomoduladora in vitro. Devido ao seu valor nutritivo e potencial terapêutico, as folhas e as sementes dessa árvore são consumidas em algumas comunidades. Algumas lectinas de plantas não são tóxicas para mamíferos, mas tem sido relatado que outras são prejudiciais quando ingeridas ou administradas por outros meios.Objetivo: Como um dos passos necessários para determinar a segurança de WSMoL, nós avaliamos os possíveis efeitos cardiotóxicos desta proteína purificada.Métodos: Durante 21 dias consecutivos, a WSMoL foi administrada a camundongos por gavagem. Foram investigadas as funções eletrofisiológicas, mecânicas e metabólicas in vivo e ex vivo por meio de registros eletrocardiográficos, ressonância magnética nuclear e respirometria de alta resolução. Resultados: O tratamento com WSMoL não induziu alterações nos níveis de glicose no sangue ou peso corporal emcomparação com o grupo controle. Adicionalmente, as relações peso cardíaco/peso corporal e peso cardíaco/comprimento tibial estavam semelhantes em ambos os grupos. A ingestão de lectina também não modificou a tolerância à glicose ou resistência à insulina. Não foram observadas alterações nos parâmetros eletrocardiográficos ou na duração do potencial de ação cardíaco. Os corações dos camundongos dos grupos controle e WSMoL mostraram função ventricular esquerda preservada. Além disso, a WSMoL não induziu alterações na função mitocondrial (em todos os casos, p > 0,05). Conclusões: A administração de WSMoL demonstrou ter um perfil de segurança cardíaca. Estes resultados contribuem à avaliação de segurança do uso de sementes de M. oleifera para tratar água, visto que essa lectina está presente na preparação empregada por algumas populações com esse fim. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0) Palavras-chave: Moringa Oleifera; Lectinas; Glicosídeos; Carboidratos; Coração; Segurança Hídrica; Camundongos. AbstractBackground: Moringa oleifera seeds, which are used for water clarification, contain a lectin named WSMoL which has shown in vitro antibacterial and immunomodulatory activity. Due to their nutritional value and therapeutic potential, the leaves and seeds of this tree are eaten in some communities. Some plant lectins are non-toxic to mammals, but others have been reported to be harmful when ingested or administered by other means.Objective: As one of the steps needed to define the safety of WSMoL, we evaluated possible cardiotoxic effects of this purified protein.Methods: WSMoL was administered for 21 consecutive days to mice by gavage. Electrophysiological, mechanical, and metabolic cardiac functions were investigated by in vivo and ex vivo electrocardiographic recordings, nuclear magnetic resonance, and high-resolution respirometry. Results:The treatment with WSMoL did not induce changes in blood glucose levels or body weight in comparison with control group. Moreover, ...

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“…The safety profile of macrolides requires accurate scrutiny due to the popularity and widespread use of them. Despite the obvious benefits in the treatment of several infectious diseases, some studies suggest that these antibiotics may induce cardiac toxicity recognized most commonly in patients already have experienced cardiovascular diseases [9,10]. This rare adverse cardiovascular toxic effect is mainly manifested by prolongation of the QT interval on the electrocardiogram (ECG).…”

Section: Introductionmentioning

confidence: 99%

“…The QT prolongation and cardiac arrhythmias that are attributed to macrolides may be presenting as fatal Torsade de Pointes (TdP), and sudden cardiac death especially in patients with coronary heart disease. Even though the reports indicate that macrolide treatment may cause low incidence of cardiotoxicity, these side effects have raised more attention recently [9][10][11]. The Food and Drug Administration (FDA) has warned the public and health care professionals regarding the potentially life-threating arrhythmias, QT prolongation, TdP, and sudden cardiac deaths with azithromycin, clarithromycin, and erythromycin [12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Comparative Study of the Effect of Macrolide Antibiotics Erythromycin, Clarithromycin, and Azithromycin on the ERG1 Gene Expression in H9c2 Cardiomyoblast Cells

et al. 2020

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Macrolides are clinically well-established class of antibiotics. Macrolides induce cardiotoxicity by blocking ether-a-go-go–related gene (ERG) potassium channels in cardiac myocytes. The aim of this study was to compare the effects of erythromycin, clarithromycin and azithromycin on cell viability and expression of ERG1 gene in H9c2 cells. Cell viability and ERG1 gene expression of H9c2 cells in 3 different concentrations, 1, 10 and 25 µg/ml, after 48 and 72 h were determined by MTT test and Real time-PCR method respectively. After 48 h, the growth of H9c2 cells treated with erythromycin, clarithromycin and Azithromycin (except two doses) were inhibited significantly compared to control group (p<0.05). All three groups of antibiotics showed toxic effects on cells after 72 h in all concentrations. Azithromycin-inhibiting effects were significantly higher than two other groups after 72 h of treatment. The expression of ERG1 gene increased in all three groups of antibiotics by increasing the concentration and duration of treatment. Azithromycin had the most pronounced effect on ERG1 expression in 48 and 72 h. This study indicated that these macrolides affect ERG1 expression due to their potential cardiac adverse effects. Further investigations are required to understand the exact mechanism of cardiotoxicity associated with macrolides.

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Macrolides use and the risk of sudden cardiac death

Cited by 5 publications

References 33 publications

Magnitude of Coagulation Abnormalities and Associated Factors Among Patients with Heart Diseases at the University of Gondar Comprehensive Specialized Hospital

Magnitude of Coagulation Abnormalities and Associated Factors Among Patients with Heart Diseases at the University of Gondar Comprehensive Specialized Hospital

Avaliação dos Efeitos Cardíacos de Lectina Solúvel em Água (WSMoL) de Sementes de Moringa Oleifera

Comparative Study of the Effect of Macrolide Antibiotics Erythromycin, Clarithromycin, and Azithromycin on the ERG1 Gene Expression in H9c2 Cardiomyoblast Cells

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