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Risk Factors for QT Prolongation in Patients with Chronic Hydroxychloroquine Use.

Yu Liao1, Ping-Yen Liu1,2, Mu-Shiang Huang1

  • 1Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University.

Acta Cardiologica Sinica
|November 28, 2022
PubMed
Summary
This summary is machine-generated.

Long-term hydroxychloroquine use did not significantly alter QTc interval. However, diabetes and other QT-prolonging drugs increase the risk of significant QTc prolongation in these patients.

Keywords:
HydroxychloroquineQT prolongation

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Area of Science:

  • Pharmacology
  • Cardiology
  • Clinical Medicine

Background:

  • Hydroxychloroquine (HCQ) is an antimalarial and immunomodulator.
  • HCQ use can lead to QT interval prolongation, potentially causing fatal arrhythmias.
  • Investigating risk factors for QTc prolongation in long-term HCQ users is crucial.

Purpose of the Study:

  • To investigate changes in the QT interval in patients on long-term hydroxychloroquine therapy.
  • To identify risk factors associated with significant corrected QT (QTc) prolongation.
  • To analyze predictors of QTc interval response in HCQ users.

Main Methods:

  • Retrospective analysis of 3603 patients on long-term HCQ from 2009-2019.
  • ECG data from 167 patients before and during HCQ therapy were reviewed.
  • Multivariable logistic and linear regression models were used to identify risk factors and predict QTc response.

Main Results:

  • No significant change in QTc interval was observed between baseline and during HCQ treatment (451.1 ± 39.9 ms vs. 456.0 ± 37.3 ms, P = 0.140).
  • Diabetes mellitus (OR: 9.55) and concurrent use of additional QT-prolonging drugs (OR: 2.89) were independent risk factors for significant QTc prolongation.
  • Multiple linear regression predicted QTc response with an adjusted R² of 0.385, considering QT-prolonging drugs and comorbidities.

Conclusions:

  • Long-term hydroxychloroquine users with diabetes mellitus and those using additional QT-prolonging drugs face a higher risk of significant QTc prolongation.
  • Baseline QTc interval, concurrent medications, and comorbidities are significant predictors of QTc response in HCQ users.