QT interval is not prolonged in patients with eating disorders

Rollin, Anne; Bérard, Émilie; Valet, Maxime; Saulnier, Aure; Hazane, Franck; Ritz, Patrick

doi:10.1016/j.ijcard.2014.09.055

Cited by 10 publications

(11 citation statements)

References 8 publications

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“…However, the small number of observations in the two studies results in a relatively large uncertainty of the estimates. The most recent study examining 100 patients with AN or BN or mixed found no risk of prolonged QTc, (Vaurs et al, ) which is in‐line with our findings. Furthermore, we found no association between the severity of purging behavior and QTc interval, which is in contrast with another study, including 86 patients with BN, which found a longer mean QTc in patients with BN who purged compared with nonpurging patients with BN (Takimoto et al, ).…”

Section: Discussionsupporting

confidence: 92%

“…In addition, several drugs may alter the duration of the QTc interval such as antipsychotics, antihistamines, and selective serotonin reuptake inhibitors (SSRI's) (Fanoe et al, 2014). It has been suggested that patients with BN have an increased risk of prolonged QTc interval, but previous studies are small and some are based on poorly defined study populations (Panagiotopoulos, McCrindle, Hick, & Katzman, 2000;Takimoto et al, 2004;Takimoto, Yoshiuchi, & Akabayashi, 2008;Vaurs et al, 2014). Accordingly, evidence is sparse and inconclusive.…”

Section: Introductionmentioning

confidence: 99%

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The QTc interval and risk of cardiac events in bulimia nervosa: A long‐term follow‐up study

Frederiksen

Christiansen

Østergaard

et al. 2018

Intl J Eating Disorders

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Objective An association between bulimia nervosa (BN) and prolonged corrected QT interval (QTc) in the electrocardiogram has been suggested, but results of previous studies are conflicting, and the risk of cardiac events in patients with BN has yet to be investigated. Method We estimated mean QTc interval and relative risk of borderline (QTc >440 ms) and prolonged QTc (QTc >460 ms) between adult women with BN (N = 531) and healthy controls (N = 123). In follow‐up analyses, we investigated the risk of a primary endpoint (syncope, ventricular tachycardia, and cardiac arrest) and all‐cause mortality in patients with BN (N = 702) compared with a population‐based cohort derived from the Danish Civil Register (N = 7,020). Results Mean QTc did not differ between patients with BN and controls. Relative risk of borderline prolonged QTc was 2.3 (p = 0.28). The number of patients and controls with prolonged QTc was small, and the risk did not differ between patients with BN and controls. Median follow‐up was 10.6 years. Although there appeared to be increased risks after 5 years of follow‐up, long‐term risks of the primary endpoint (Hazard ratio [HR] = 1.4, p = 0.37) and all‐cause mortality (HR = 1.7, p = .28), respectively, were not increased in patients with BN compared to a population‐based cohort. Discussion Mean QTc did not differ between patients with BN and healthy controls, and the risk of prolonged QTc was not increased in patients with BN. There was no difference in the long‐term risk of cardiac events, and long‐term all‐cause mortality did not differ significantly between patients with BN and a population‐based cohort.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

The QTc interval and risk of cardiac events in bulimia nervosa: A long‐term follow‐up study

Frederiksen

Christiansen

Østergaard

et al. 2018

Intl J Eating Disorders

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“…Similarly, in a smaller study of adult patients with severe anorexia nervosa, the QTc interval did not differ from age‐matched controls . In a larger recent study of 100 less severely ill adult patients, QTc intervals were not noted to be longer in patients with anorexia nervosa versus controls . Also, an older study of severely ill adult female patients with anorexia nervosa did not find QTc prolongation except in those with hypokalemia.…”

Section: Methodsmentioning

confidence: 78%

Cardiovascular complications of anorexia nervosa: A systematic review

Sachs

Harnke

Mehler

et al. 2015

Intl J Eating Disorders

181

172

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It is reasonable to obtain routine electrocardiography and measurements of orthostatic vital signs in patients presenting with anorexia nervosa. Echocardiography is generally not indicated unless prompted by clinical signs of disease. Admission to an inpatient unit with telemetry monitoring is recommended for patients with severe sinus bradycardia or junction rhythm, marked prolongation of the corrected QT interval, or syncope.

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“…QT interval prolongation on an electrocardiogram (EKG) has been a frequently discussed topic with regard to eating disorders. Although once felt to be inherent to anorexia nervosa, current teaching suggests that QT prolongation is not indigenous to anorexia nervosa . Rather, current evidence suggests that the finding of QT prolongation on the EKG is more likely due to medication side effects or is related to hypokalemia from purging behaviors in the binge‐purge subtypes or due to refeeding the restricting subtypes …”

Section: Complications Of Hypokalemiamentioning

confidence: 97%