Gender differences in the proarrhythmic potential of QT-prolonging drugs.
Female gender is associated with an increased risk of torsades de pointes (TDP) in the setting of drugs that can prolong the QT interval. These drugs are all potassium channel blocking agents and include many frequently used antiarrhythmic drugs, as well as a variety of noncardiac medications. The mechanism of this gender difference is unknown. Some women at risk are silent carriers of the long QT syndrome. The concept of "repolarization reserve" can help predict which individuals are at risk for developing drug-induced TDP. Generic formulations of QT-prolonging drugs have the potential to increase proarrhythmic risk to women. Female subjects need to be well represented in the testing of new potassium channel blocking drugs.
Wolbrette
Deborah
D
Section of Cardiology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, MC H047, 500 University Drive, Hershey, PA 17033, USA. dwolbrette@psu.edu
D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D016568:Drugs, Generic / Q000009:adverse effects; D004594:Electrophysiology; D005260:Female; D006801:Humans; D008297:Male; D026902:Potassium Channel Blockers / Q000009:adverse effects*; D015221:Potassium Channels / Q000187:drug effects; D012737:Sex Factors; D016171:Torsades de Pointes / Q000139:chemically induced*
D000889:Anti-Arrhythmia Agents; D016568:Drugs, Generic; D026902:Potassium Channel Blockers; D015221:Potassium Channels