QT interval prolongation in users of selective serotonin reuptake inhibitors in an elderly surgical population: a cross-sectional study

TY - JOUR

T1 - QT interval prolongation in users of selective serotonin reuptake inhibitors in an elderly surgical population

T2 - a cross-sectional study

AU - van Haelst, Ingrid M M

AU - van Klei, Wilton A

AU - Doodeman, Hieronymus J

AU - Warnier, Miriam J

AU - De Bruin, Marie L

AU - Kalkman, Cor J

AU - Egberts, Toine C G

N1 - © Copyright 2014 Physicians Postgraduate Press, Inc.

PY - 2014/1

Y1 - 2014/1

N2 - OBJECTIVE: To investigate the association between the use of a selective serotonin reuptake inhibitor (SSRI) and the occurrence of QT interval prolongation in an elderly surgical population.METHOD: A cross-sectional study was conducted among patients (> 60 years) scheduled for outpatient preanesthesia evaluation in the period 2007 until 2012. The index group included elderly users of an SSRI. The reference group of nonusers of antidepressants was matched to the index group on sex and year of scheduled surgery (ratio, 1:1). The primary outcome was the occurrence of QT interval prolongation shown on electrocardiogram. The QT interval was corrected for heart rate (QTc interval). The secondary outcome was the duration of the QTc interval. The outcomes were adjusted for confounding by using regression techniques.RESULTS: The index and reference groups included 397 users of an SSRI and 397 nonusers, respectively. QTc interval prolongation occurred in 25 (6%) and 19 (5%) index and reference patients, respectively. After adjustment for confounding, users of an SSRI did not have a higher risk for QTc interval prolongation compared to nonusers: OR = 1.1 (95% CI, 0.5 to 2.0). The adjusted mean QTc interval length in users of an SSRI and nonusers was comparable (difference of 1.5 milliseconds [95% CI, -1.8 to 4.8]). Use of the most frequently used SSRIs citalopram and paroxetine was not associated with a higher risk of QTc interval prolongation nor with lengthening of the QTc interval duration.CONCLUSIONS: The use of an SSRI by elderly surgical patients was not associated with the occurrence of QT interval prolongation.

AB - OBJECTIVE: To investigate the association between the use of a selective serotonin reuptake inhibitor (SSRI) and the occurrence of QT interval prolongation in an elderly surgical population.METHOD: A cross-sectional study was conducted among patients (> 60 years) scheduled for outpatient preanesthesia evaluation in the period 2007 until 2012. The index group included elderly users of an SSRI. The reference group of nonusers of antidepressants was matched to the index group on sex and year of scheduled surgery (ratio, 1:1). The primary outcome was the occurrence of QT interval prolongation shown on electrocardiogram. The QT interval was corrected for heart rate (QTc interval). The secondary outcome was the duration of the QTc interval. The outcomes were adjusted for confounding by using regression techniques.RESULTS: The index and reference groups included 397 users of an SSRI and 397 nonusers, respectively. QTc interval prolongation occurred in 25 (6%) and 19 (5%) index and reference patients, respectively. After adjustment for confounding, users of an SSRI did not have a higher risk for QTc interval prolongation compared to nonusers: OR = 1.1 (95% CI, 0.5 to 2.0). The adjusted mean QTc interval length in users of an SSRI and nonusers was comparable (difference of 1.5 milliseconds [95% CI, -1.8 to 4.8]). Use of the most frequently used SSRIs citalopram and paroxetine was not associated with a higher risk of QTc interval prolongation nor with lengthening of the QTc interval duration.CONCLUSIONS: The use of an SSRI by elderly surgical patients was not associated with the occurrence of QT interval prolongation.

KW - Aged

KW - Aged, 80 and over

KW - Cross-Sectional Studies

KW - Electrocardiography

KW - Female

KW - Humans

KW - Long QT Syndrome

KW - Male

KW - Middle Aged

KW - Risk

KW - Serotonin Uptake Inhibitors

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.4088/JCP.13m08397

DO - 10.4088/JCP.13m08397

M3 - Journal article

C2 - 24345304

SN - 0160-6689

VL - 75

SP - 15

EP - 21

JO - Journal of Clinical Psychiatry

JF - Journal of Clinical Psychiatry

IS - 1

ER -