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No. 3 (2023)

PRACTICE

Prevalence and Risk Factors for Long QT Interval Syndrome in Patients of the City Psychiatric Hospital

https://doi.org/10.21265/PSYPH.2023.60.92.006

Published 2023-09-30

  • D.I. Malin
    • ,
  • D.R. Bulatova
    • ,
  • L.Yu. Shchustova
    • ,
  • R.P. Gordeeva

D.I. Malin
Moscow Research Institute of Psychiatry, Serbsky National Medical Research Center of Psychiatry and Narcology

D.R. Bulatova
Moscow Research Institute of Psychiatry, Serbsky National Medical Research Center of Psychiatry and Narcology

L.Yu. Shchustova
Psychiatric Clinical Hospital No 4 of Department of Health Care of Moscow named after P.B. Gannushkin

R.P. Gordeeva
Moscow Research Institute of Psychiatry, Serbsky National Medical Research Center of Psychiatry and Narcology

Abstract

The aim – identification of the frequency of occurrence and risk factors for the long QT-interval syndrome among patients of the city psychiatric hospital.
Patients and methods. In this study we analyzed 2140 electrocardiograms (ECGs) of 999 men and 1241 women who have been treated over a two-month period. In patients with identified increase of the QT interval (over 450 ms in men and over 470 ms in women), medical records were screened for diagnosis, demographic characteristics, the presence of concomitant medical diseases and pharmacotherapy. The Medication Appropriateness Index (MAI) was used to assess the rationality of the use of pharmacological agents. To determine the severity of the effect of each drug on the QT interval, data from the Internet resource CredibleMeds® were used.
Result. Long QT interval syndrome was detected in 42 patients (1.96 % of cases), including 15 men (1.5 % of cases) and 27 women (2.2 % of cases). In 9 patients (0.4 % of cases) a critical increase in the QT interval over 500 ms was revealed. The mean age of the patients was 58.6 ± 2.7 years, and the group average was 46.0 ±5.6 years (t = 2.48; p < 0.005). In percentage terms, long QT syndrome was most often detected in patients with dementia compared with other mental disorders. Severe chronic somatic diseases were detected in 37 patients (88.1 % of cases), including diseases of the cardiovascular system in 33 patients (78.6 % of cases). Patients simultaneously received an average of 5.96 ± 0.32 medications. Of these, 25 patients (59.5 % of cases) were prescribed with medications with high risk of QT interval prolongation. Antipsychotic polypharmacy with the prescription of 2 or more antipsychotics was detected in 12 patients (28.6 % of cases). The rationality index for the use of pharmacological agents MAI averaged 3.24 ± 0.25 points.
Conclusion. The long QT interval syndrome was more prevalent among patients from the city psychiatric hospital compared with general population. Risk factors for the development of long QT-interval syndrome in patients with mental disorders included: middle and older age, the presence of chronic diseases of the cardiovascular system, polypharmacy with the simultaneous prescription of several medications with cardiotoxic side effects.

Keywords

QT interval, mental disorders, risk factors, polypharmacy, drug interactions

PDF (Русский)

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