Alex F Manini1, Barry Stimmel2, David Vlahov3. 1. Division of Medical Toxicology, the Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: alex.manini@mountsinai.org. 2. Cardiology Division, the Icahn School of Medicine at Mount Sinai, New York, NY, USA. 3. School of Nursing, University of California at San Francisco, CA.
Abstract
BACKGROUND AND PURPOSE: QT prolongation independently predicts adverse cardiovascular events in suspected poisoning. We aimed to evaluate the association between race and drug-induced QT prolongation for patients with acute overdose. METHODS: This was a cross-sectional observational study at two urban teaching hospitals. Consecutive adult ED patients with acute drug overdose were prospectively enrolled over a two year period. The primary outcome, long-QT, was defined using standard criteria: QTc>470 ms in females and>460 ms in males. The association between race and drug-induced QT prolongation was tested, considering several confounding variables. RESULTS: In 472 patients analyzed (46% female, mean age 42.3), QT prolongation occurred in 12.7%. Blacks had two-fold increased odds of drug-induced QT prolongation (OR 2.01, CI 1.03-3.91) and Hispanics had 48% decreased odds of drug-induced QT prolongation (OR 0.52, CI 0.29-0.94). CONCLUSIONS: We found significant racial susceptibility to drug-induced QT prolongation in this large urban study of acute overdoses.
BACKGROUND AND PURPOSE:QT prolongation independently predicts adverse cardiovascular events in suspected poisoning. We aimed to evaluate the association between race and drug-induced QT prolongation for patients with acute overdose. METHODS: This was a cross-sectional observational study at two urban teaching hospitals. Consecutive adult ED patients with acute drug overdose were prospectively enrolled over a two year period. The primary outcome, long-QT, was defined using standard criteria: QTc>470 ms in females and>460 ms in males. The association between race and drug-induced QT prolongation was tested, considering several confounding variables. RESULTS: In 472 patients analyzed (46% female, mean age 42.3), QT prolongation occurred in 12.7%. Blacks had two-fold increased odds of drug-induced QT prolongation (OR 2.01, CI 1.03-3.91) and Hispanics had 48% decreased odds of drug-induced QT prolongation (OR 0.52, CI 0.29-0.94). CONCLUSIONS: We found significant racial susceptibility to drug-induced QT prolongation in this large urban study of acute overdoses.
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