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Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis
BACKGROUND: The association between oral fluoroquinolones (FQs) usage and risk of severe arrhythmia-related events (ventricular arrhythmias and sudden cardiac death) remains controversial. Therefore we aimed to quantify this association and to evaluate the effects of FQs on adverse cardiovascular (C...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682775/ https://www.ncbi.nlm.nih.gov/pubmed/29095256 http://dx.doi.org/10.1097/MD.0000000000008273 |
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author | Liu, Xiao Ma, Jianyong Huang, Lin Zhu, Wengen Yuan, Ping Wan, Rong Hong, Kui |
author_facet | Liu, Xiao Ma, Jianyong Huang, Lin Zhu, Wengen Yuan, Ping Wan, Rong Hong, Kui |
author_sort | Liu, Xiao |
collection | PubMed |
description | BACKGROUND: The association between oral fluoroquinolones (FQs) usage and risk of severe arrhythmia-related events (ventricular arrhythmias and sudden cardiac death) remains controversial. Therefore we aimed to quantify this association and to evaluate the effects of FQs on adverse cardiovascular (CV) outcomes. METHODS: We retrieved data from the Cochrane Collaboration, PubMed, and China National Knowledge Infrastructure (CNKI) databases until August 2017. The studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of interest were included. Data were extracted from the eligible articles, and we used a random effects model to calculate the effect estimates. RESULTS: Of the 16 studies that were included, 7 studies included serious arrhythmias, 3 studies included CV death, and 11 studies included all-cause death. The pooled RRs of FQs use were: 2.29 (95% CI: 1.20–4.36, P = .01) for serious arrhythmias; 1.60 (95% CI: 1.17–2.20, P = .004) for CV death; and 1.02 (95% CI: 0.76–1.37, P = .92) for all-cause death. The RRs associated with serious arrhythmias were 6.27 for gatifloxacin, 4.20 for moxifloxacin, 1.73 for ciprofloxacin, and 1.41 for levofloxacin. Current FQs users showed an increased risk of serious arrhythmias in the subgroup analysis. Treatment with FQs is associated with an absolute risk increase of 160 additional sudden deaths or ventricular arrhythmias, and 43 additional CV deaths per 1 million treatment courses. CONCLUSION: The use of FQs could increase the risk of serious arrhythmias and CV death but not increase or all-cause death. Moreover, moxifloxacin and levofloxacin showed a higher risk of serious arrhythmias. |
format | Online Article Text |
id | pubmed-5682775 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-56827752017-11-28 Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis Liu, Xiao Ma, Jianyong Huang, Lin Zhu, Wengen Yuan, Ping Wan, Rong Hong, Kui Medicine (Baltimore) 3400 BACKGROUND: The association between oral fluoroquinolones (FQs) usage and risk of severe arrhythmia-related events (ventricular arrhythmias and sudden cardiac death) remains controversial. Therefore we aimed to quantify this association and to evaluate the effects of FQs on adverse cardiovascular (CV) outcomes. METHODS: We retrieved data from the Cochrane Collaboration, PubMed, and China National Knowledge Infrastructure (CNKI) databases until August 2017. The studies that reported relative risk (RR) estimates with 95% confidence intervals (CIs) for the associations of interest were included. Data were extracted from the eligible articles, and we used a random effects model to calculate the effect estimates. RESULTS: Of the 16 studies that were included, 7 studies included serious arrhythmias, 3 studies included CV death, and 11 studies included all-cause death. The pooled RRs of FQs use were: 2.29 (95% CI: 1.20–4.36, P = .01) for serious arrhythmias; 1.60 (95% CI: 1.17–2.20, P = .004) for CV death; and 1.02 (95% CI: 0.76–1.37, P = .92) for all-cause death. The RRs associated with serious arrhythmias were 6.27 for gatifloxacin, 4.20 for moxifloxacin, 1.73 for ciprofloxacin, and 1.41 for levofloxacin. Current FQs users showed an increased risk of serious arrhythmias in the subgroup analysis. Treatment with FQs is associated with an absolute risk increase of 160 additional sudden deaths or ventricular arrhythmias, and 43 additional CV deaths per 1 million treatment courses. CONCLUSION: The use of FQs could increase the risk of serious arrhythmias and CV death but not increase or all-cause death. Moreover, moxifloxacin and levofloxacin showed a higher risk of serious arrhythmias. Wolters Kluwer Health 2017-11-03 /pmc/articles/PMC5682775/ /pubmed/29095256 http://dx.doi.org/10.1097/MD.0000000000008273 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0 |
spellingShingle | 3400 Liu, Xiao Ma, Jianyong Huang, Lin Zhu, Wengen Yuan, Ping Wan, Rong Hong, Kui Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis |
title | Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis |
title_full | Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis |
title_fullStr | Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis |
title_full_unstemmed | Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis |
title_short | Fluoroquinolones increase the risk of serious arrhythmias: A systematic review and meta-analysis |
title_sort | fluoroquinolones increase the risk of serious arrhythmias: a systematic review and meta-analysis |
topic | 3400 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682775/ https://www.ncbi.nlm.nih.gov/pubmed/29095256 http://dx.doi.org/10.1097/MD.0000000000008273 |
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