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Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data

Drug-induced QT prolongation is one of the most common side effects of drug use and can cause fatal outcomes such as sudden cardiac arrest. This study adopts the data-driven approach to assess the QT prolongation risk of all the frequently used drugs in a tertiary teaching hospital using both standa...

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Autores principales: Choi, Byung Jin, Koo, Yeryung, Kim, Tae Young, Lim, Hong-Seok, Yoon, Dukyong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803188/
https://www.ncbi.nlm.nih.gov/pubmed/35100302
http://dx.doi.org/10.1371/journal.pone.0263117
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author Choi, Byung Jin
Koo, Yeryung
Kim, Tae Young
Lim, Hong-Seok
Yoon, Dukyong
author_facet Choi, Byung Jin
Koo, Yeryung
Kim, Tae Young
Lim, Hong-Seok
Yoon, Dukyong
author_sort Choi, Byung Jin
collection PubMed
description Drug-induced QT prolongation is one of the most common side effects of drug use and can cause fatal outcomes such as sudden cardiac arrest. This study adopts the data-driven approach to assess the QT prolongation risk of all the frequently used drugs in a tertiary teaching hospital using both standard 12-lead ECGs and intensive care unit (ICU) continuous ECGs. We used the standard 12-lead ECG results (n = 1,040,752) measured in the hospital during 1994–2019 and the continuous ECG results (n = 4,835) extracted from the ICU’s patient-monitoring devices during 2016–2019. Based on the drug prescription frequency, 167 drugs were analyzed using 12-lead ECG data under the case-control study design and 60 using continuous ECG data under the retrospective cohort study design. Whereas the case-control study yielded the odds ratio, the cohort study generated the hazard ratio for each candidate drug. Further, we observed the possibility of inducing QT prolongation in 38 drugs in the 12-lead ECG analysis and 7 drugs in the continuous ECG analysis. The seven drugs (vasopressin, vecuronium, midazolam, levetiracetam, ipratropium bromide, nifedipine, and chlorpheniramine) that showed a significantly higher risk of QT prolongation in the continuous ECG analysis were also identified in the 12-lead ECG data analysis. The use of two different ECG sources enabled us to confidently assess drug-induced QT prolongation risk in clinical practice. In this study, seven drugs showed QT prolongation risk in both study designs.
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spelling pubmed-88031882022-02-01 Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data Choi, Byung Jin Koo, Yeryung Kim, Tae Young Lim, Hong-Seok Yoon, Dukyong PLoS One Research Article Drug-induced QT prolongation is one of the most common side effects of drug use and can cause fatal outcomes such as sudden cardiac arrest. This study adopts the data-driven approach to assess the QT prolongation risk of all the frequently used drugs in a tertiary teaching hospital using both standard 12-lead ECGs and intensive care unit (ICU) continuous ECGs. We used the standard 12-lead ECG results (n = 1,040,752) measured in the hospital during 1994–2019 and the continuous ECG results (n = 4,835) extracted from the ICU’s patient-monitoring devices during 2016–2019. Based on the drug prescription frequency, 167 drugs were analyzed using 12-lead ECG data under the case-control study design and 60 using continuous ECG data under the retrospective cohort study design. Whereas the case-control study yielded the odds ratio, the cohort study generated the hazard ratio for each candidate drug. Further, we observed the possibility of inducing QT prolongation in 38 drugs in the 12-lead ECG analysis and 7 drugs in the continuous ECG analysis. The seven drugs (vasopressin, vecuronium, midazolam, levetiracetam, ipratropium bromide, nifedipine, and chlorpheniramine) that showed a significantly higher risk of QT prolongation in the continuous ECG analysis were also identified in the 12-lead ECG data analysis. The use of two different ECG sources enabled us to confidently assess drug-induced QT prolongation risk in clinical practice. In this study, seven drugs showed QT prolongation risk in both study designs. Public Library of Science 2022-01-31 /pmc/articles/PMC8803188/ /pubmed/35100302 http://dx.doi.org/10.1371/journal.pone.0263117 Text en © 2022 Choi et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Choi, Byung Jin
Koo, Yeryung
Kim, Tae Young
Lim, Hong-Seok
Yoon, Dukyong
Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data
title Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data
title_full Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data
title_fullStr Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data
title_full_unstemmed Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data
title_short Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data
title_sort data-driven drug-induced qt prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803188/
https://www.ncbi.nlm.nih.gov/pubmed/35100302
http://dx.doi.org/10.1371/journal.pone.0263117
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