QT Prolongation in Cancer Patients.
QT Prolongation in Cancer Patients.
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DOI：
10.3389/fcvm.2021.613625
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发表时间：
2021
影响因子：
3.6
通讯作者：
Lopez-Mattei J
中科院分区：
文献类型：
--
作者：
Kim P;Masha L;Olson A;Iliescu C;Karimzad K;Hassan S;Palaskas N;Durand JB;Leung CH;Lopez-Mattei J
背景：QT延长和尖端扭矩是心脏病学家和肿瘤学家主要关注的问题。虽然癌症患者被怀疑QT间期延长，但这还没有在大量人群中进行调查。这项研究的目的是分析癌症人群的QT间期分布，并将其与同一机构中的非癌症人群进行比较。方法：本研究是对2009年1月至2013年12月在德克萨斯大学MD Anderson癌症中心进行的82,410例癌症患者(51.8%女性和48.2%男性)和775例正常干细胞捐献者(47.9%女性和52.1%男性)进行的ECG的回顾性研究。同时收集和分析了同一时期的药房处方数据。使用Bazett和Fridericia公式校正心率的QT间期。结果：用Fridericia公式(QTcF)校正QT后，癌症患者QTc值的平均值为414ms，99%百分位数为473ms。这些时间明显长于正常干细胞捐献者，分别为407ms和458ms，p<；0.001。在癌症患者中，与门诊和急诊中心区域相比，住院环境中的QTC较长。最常见的QT延长处方药物是恩丹西酮和美沙酮。结论：我们的研究表明，癌症患者的QTC间期显著延长，尤其是在住院患者。经常处方的QT延长药物，如止吐和止痛药，可能与我们肿瘤医院看到的QT延长有关。
Background: QT prolongation and torsades de pointes pose a major concern for cardiologists and oncologists. Although cancer patients are suspected to have prolonged QT intervals, this has not been investigated in a large population. The purpose of this study was to analyze the QT interval distribution in a cancer population and compare it to a non-cancer population in the same institution. Methods: The study was a retrospective review of 82,410 ECGs performed in cancer patients (51.8% women and 48.2% men) and 775 ECGs performed in normal stem cell donors (47.9% women and 52.1% men) from January 2009 to December 2013 at the University of Texas MD Anderson Cancer Center. Pharmacy prescription data was also collected and analyzed during the same time period. Correction of the QT interval for the heart rate was performed using the Bazett and Fridericia formulas. Results: After QT correction for heart rate by the Fridericia formula (QTcF), the mean and 99% percentile QTc for cancer patients were 414 and 473 ms, respectively. These were significantly longer than the normal stem cell donors, 407 and 458 ms, p < 0.001, respectively. Among the cancer patients, the QTc was longer in the inpatient setting when compared to both outpatient and emergency center areas. The most commonly prescribed QT prolonging medications identified were ondansetron and methadone. Conclusion: Our study demonstrates significantly longer QTc intervals in cancer patients, especially in the inpatient setting. Frequently prescribed QT prolonging medications such as antiemetics and analgesics may have a causative role in QT prolongation seen in our cancer hospital.