QT Prolongation in Patients with Early Onset Psychosis

Lubbers, J.J.M. (2015) QT Prolongation in Patients with Early Onset Psychosis. thesis, Medicine.

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Abstract

QT Prolongation in Patients with Early Onset Psychosis 2 Abstract Background Schizophrenia is a severe mental disorder, which is associated with loss of quality of life and shortened life expectancy. Within the increased risk of cardiovascular death, people with schizophrenia are more likely to have sudden cardiac death (SCD) compared with people in the general population. The QT-interval might potentiate the risk for lethal cardiac arrhythmias and SCD. Given that patients with schizophrenia often have more risk factors of QT-prolongation and there is little information about QT-interval in patients with early psychosis, this ECG-marker in this population is of interest. We aimed to determine whether QT-duration is prolonged in patients with early onset psychosis, and whether differences in QT-duration may be explained by use of QT-prolonging drugs and/or factors that influence QT-duration. Materials and methods In a retrospectective cohort study, we analyzed ECGs of a cohort of 249 patients with early psychosis. We determined whether QT-prolongation was present, and assessed QT-duration. Patient demographics, as well as data about medications use and potential risk factors were recorded. Results were compared with a cohort of age-comparable healthy medical students. Results QT-duration was significantly longer in the early psychosis cohort than in the control cohort (392.4 vs. 388.0 msec, p<0.05). QT-prolongation was more prevalent in patients (8.2%) than among controls (0.4%). Moreover, compared with patients without QT-prolonging drugs, patients with QT-prolonging drugs had a longer mean QT-duration (394.9 vs. 375.2 msec, p<0.05). All patients with QT-prolongation were within the patients group with QTc-prolonging medication. Female sex, potassium level, TC/HDL ratio, QTc-prolonging drugs and polytherapy were found to be associated with the QT-interval. Discussion and Conclusion Patients with early psychosis were found to have a longer mean QTc-interval compared with healthy controls. Moreover, prevalence of QTc-prolongation was significantly increased in patients. QTc-prolongation observed in patients with early psychosis appears primarily to be explained by use of QTc-prolonging medication. Apart from this, other non-medicamental risk factors and polytherapy are also associated with QTc-prolongation in patients with early onset psychosis.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor faculty Rijksuniversiteit Groningen: and Smit, S.G. Sicco
Supervisor name:	Local supervisor: and SEarly Psychosis Department, Academic Medical Centre and Amsterdam, The Netherlandsutterland
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:41
Last Modified:	25 Jun 2020 10:41
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/311

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