Antipsychotics in routine treatment are minor contributors to QT prolongation compared to genetics and age
| Autor: | Julian Roth, Matthias Falter, Maike Scherf-Clavel, Jürgen Deckert, Leif Hommers, Roberta Stempel, Manuel Mattheisen, Stefan Unterecker, Micha Gawlik |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Multifactorial Inheritance medicine.medical_specialty Adolescent QT prolongation Cardiac repolarization QT interval Electrocardiography Young Adult 03 medical and health sciences Sex Factors 0302 clinical medicine Internal medicine medicine Humans polygenic score Pharmacology (medical) Aged Retrospective Studies Pharmacology business.industry Age Factors Prolongation psychotic disorder Middle Aged Original Papers antipsychotic medication 030227 psychiatry Long QT Syndrome Psychiatry and Mental health Psychotic Disorders Cardiology Female business 030217 neurology & neurosurgery Antipsychotic Agents |
| Zdroj: | Journal of Psychopharmacology (Oxford, England) |
| ISSN: | 1461-7285 0269-8811 |
| DOI: | 10.1177/02698811211003477 |
| Popis: | Background: Drug-induced prolongation of cardiac repolarization limits the treatment with many psychotropic drugs. Recently, the contribution of polygenic variation to the individual duration of the QT interval was identified. Aims: To explore the interaction between antipsychotic drugs and the individual polygenic influence on the QT interval. Methods: Retrospective analysis of clinical and genotype data of 804 psychiatric inpatients diagnosed with a psychotic disorder. The individual polygenic influence on the QT interval was calculated according to the method of Arking et al. Results: Linear regression modelling showed a significant association of the individual polygenic QT interval score (ßstd = 0.176, p < 0.001) and age (ßstd = 0.139, p < 0.001) with the QTc interval corrected according to Fridericia’s formula. Sex showed a nominal trend towards significance (ßstd = 0.064, p = 0.064). No association was observed for the number of QT prolonging drugs according to AZCERT taken. Subsample analysis ( n = 588) showed a significant association of potassium serum concentrations with the QTc interval (ßstd = −0.104, p = 0.010). Haloperidol serum concentrations were associated with the QTc interval only in single medication analysis ( n = 26, ßstd = 0.101, p = 0.004), but not in multivariate regression analysis. No association was observed for aripiprazole, clozapine, quetiapine and perazine, while olanzapine and the sum of risperidone and its metabolite showed a negative association. Conclusions: Individual genetic factors and age are main determinants of the QT interval. Antipsychotic drug serum concentrations within the therapeutic range contribute to QTc prolongation on an individual level. |
| Databáze: | OpenAIRE |
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