gms | German Medical Science

Background and aim: Life-threatening Torsade-de-Pointes-Arrhythmia can be triggered off as a an unwanted effect by different drugs. Because these unwanted effects are often undiscovered, their frequency is probably underestimated. The aim of this survey is to investigate the difference in the frequency of hospital stays between diabetics or patients with coronary-heart-disease, who have been probably treated with potentially QT-Time-Extending medicaments, and diabetics or coronary-heart-disease-patients without such treatment.

Methods and material: On the basis of office-based doctor’s diagnostic data (ICD-10-GM 2005) of the 2. quarter of 2005, patients, insured by company health insurance funds, older than 55 years with a diabetic mellitus or coronary-heart-disease diagnosis had been selected. The drug prescription data of the 3. quarter of 2005 of the selected patients had been analysed according to the prescription of QT-Extending substances (expanded AZERT-list) and according to possible hospital stays on the basis of admission and discharge diagnoses (main and ancillary diagnosis).

Results: The number of hospital stays of the selected patients, insured by company health insurance funds, up to 50 days after the prescription of QT-Time-Extending is 2,9 times higher with diabetics and 2,3 times higher with coronary-heart-disease -patients than the number of hospital stays of diabetics and KHK-patients with no QT-Time-Extending prescription at all. Because of cardiac arrhythmia (main and ancillary diagnosis) the number of hospital stays of the group of diabetics with a QT-Time-Extending prescription is 4 times higher and the number of hospital stays of KHK-patients is 2.8 times higher than of those patients with no QT-Time-Extending prescription. Excluding antiarrythmics, the following groups of agents: 5-HT3-antagonists, antipsychotics, gyrase inhibitors, telithromycin and clindamycin and according to patients with coronary-heart-disease additionally antiasthmatics seem to induce in proportion the most hospital stays with a diagnosis of arrhythmia.

Conclusion: The taking of potential OT-Time-Extending substances probably augments the risk of a hospital stay on the basis of cardiac arrhythmia. It seems as well that the individual substances depending on the primary disease show a different arrhythmia inducing capability on patients with diabetic mellitus diagnosis or coronary-heart-disease -patients.