Mechanisms and management of drug‐induced <scp>QT</scp> prolongation

Parsons, G.

doi:10.1002/psb.2023

Cited by 1 publication

(1 citation statement)

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“…Therefore, physicians need to have careful consideration when prescribing medications that can potentially further prolong the QTc interval in these patients and result in fatal complications such as torsades de pointes. Macrolides, commonly used in the treatment of acute chest syndrome, 52 erythromycin as an alternative to penicillin for prophylaxis against invasive pneumococcal disease in children, 53 fluoroquinolones used as alternatives in community‐acquired pneumonia 54 and osteomyelitis, 55 opioids such as methadone used frequently in pain crisis episodes and chronic pain management, 52 and ondansetron employed as an anti‐emetic, 56 all have the potential to induce and worsen QTc prolongation 57 . Therefore, given the relatively high needs of patients with SCD for medication that could potentially prolong the QTc interval, the high prevalence of prolonged QTc interval in this population, and the risk of highly serious complications, we recommend to conduct screenings to evaluate these patients for a prolonged QT interval.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic abnormalities in patients with sickle cell disease: A systematic review and meta‐analysis

Taherifard,

Movahed,

Taherifard

et al. 2024

Pediatric Blood & Cancer

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BackgroundPrevious studies have documented that electrocardiography (ECG) can reveal a range of abnormalities, offering valuable insights into the cardiac evaluation of patients with sickle cell disease (SCD). The objective of this study is to assess the patterns of ECG abnormalities observed in these patients with SCD, and to determine their prevalence.MethodWe systematically reviewed the literature using online databases of PubMed, Scopus, Web of Science, Embase, and Google Scholar to identify original studies that reported findings of standard ECG assessments in patients with SCD. Statistical analyses were performed using the random effects model. Additional analyses including sensitivity analysis and subgroup analysis were also conducted.ResultsAnalysis of data from 59 studies involving 897,920 individuals with SCD revealed that 75% of these patients had abnormal ECG findings (67%–81%), which were predominantly nonspecific ST–T changes, left ventricular hypertrophy, T‐wave changes, prolonged corrected QT (QTc) interval, and ischemic changes. Besides, it was shown that these patients had significantly higher odds of having any ECG abnormalities (OR of 17.50, 4.68–65.49), right atrial enlargement (6.09, 1.48–25.09), left ventricular hypertrophy (3.45, 1.73–6.89), right ventricular hypertrophy (7.18, 2.28–22.57), biventricular hypertrophy (10.11, 1.99–51.38), prolonged QTc interval (5.54, 2.44–12.59), ST depression (3.34, 1.87–5.97), and T‐wave changes (5.41, 1.43–20.56). Moreover, the mean of QTc interval was significantly higher among those with SCD (23.51 milliseconds, 16.08–30.94).ConclusionOur meta‐analysis showed a higher prevalence of abnormal ECG findings among individuals with SCD. A significant proportion of these patients had various ECG abnormalities, suggesting a potential need for regular ECG assessments for patients with SCD.

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