دورية أكاديمية
Factors affecting the electrocardiographic QT interval in malaria: A systematic review and meta-analysis of individual patient data
| العنوان: | Factors affecting the electrocardiographic QT interval in malaria: A systematic review and meta-analysis of individual patient data |
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| المؤلفون: | Chan, XHS, Win, YN, Haeusler, IL, Tan, JY, Loganathan, S, Saralamba, S, Chan, SKS, Ashley, EA, Barnes, KI, Baiden, R, Bassi, PU, Djimde, A, Dorsey, G, Duparc, S, Hanboonkunupakarn, B, ter Kuile, FO, Lacerda, MVG, Nasa, A, Nosten, FH, Onyeji, CO, Pukrittayakamee, S, Siqueira, AM, Tarning, J, Taylor, WRJ, Valentini, G, van Vugt, M, Wesche, D, Day, NPJ, Huang, CL-H, Brugada, J, Price, RN, White, NJ |
| بيانات النشر: | Public Library of Science (PLoS) |
| سنة النشر: | 2020 |
| المجموعة: | Oxford University Research Archive (ORA) |
| الوصف: | Background Electrocardiographic QT interval prolongation is the most widely used risk marker for ventricular arrhythmia potential and thus an important component of drug cardiotoxicity assessments. Several antimalarial medicines are associated with QT interval prolongation. However, interpretation of electrocardiographic changes is confounded by the coincidence of peak antimalarial drug concentrations with recovery from malaria. We therefore reviewed all available data to characterise the effects of malaria disease and demographic factors on the QT interval in order to improve assessment of electrocardiographic changes in the treatment and prevention of malaria. Methods and findings We conducted a systematic review and meta-analysis of individual patient data. We searched clinical bibliographic databases (last on August 21, 2017) for studies of the quinoline and structurally related antimalarials for malaria-related indications in human participants in which electrocardiograms were systematically recorded. Unpublished studies were identified by the World Health Organization (WHO) Evidence Review Group (ERG) on the Cardiotoxicity of Antimalarials. Risk of bias was assessed using the Pharmacoepidemiological Research on Outcomes of Therapeutics by a European Consortium (PROTECT) checklist for adverse drug events. Bayesian hierarchical multivariable regression with generalised additive models was used to investigate the effects of malaria and demographic factors on the pretreatment QT interval. The meta-analysis included 10,452 individuals (9,778 malaria patients, including 343 with severe disease, and 674 healthy participants) from 43 studies. 7,170 (68.6%) had fever (body temperature ≥ 37.5°C), and none developed ventricular arrhythmia after antimalarial treatment. Compared to healthy participants, patients with uncomplicated falciparum malaria had shorter QT intervals (−61.77 milliseconds; 95% credible interval [CI]: −80.71 to −42.83) and increased sensitivity of the QT interval to heart rate changes. These ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | https://ora.ox.ac.uk/objects/uuid:da420f2c-56dd-4007-ac77-84d225ddbc60Test; https://doi.org/10.1371/journal.pmed.1003040Test |
| DOI: | 10.1371/journal.pmed.1003040 |
| الإتاحة: | https://doi.org/10.1371/journal.pmed.1003040Test https://ora.ox.ac.uk/objects/uuid:da420f2c-56dd-4007-ac77-84d225ddbc60Test |
| حقوق: | info:eu-repo/semantics/openAccess ; CC Attribution (CC BY) |
| رقم الانضمام: | edsbas.7CD7F715 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1371/journal.pmed.1003040 |
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