Possible cardioprotective effect of angiotensin-converting enzyme inhibitors during treatment of American tegumentary leishmaniasis with meglumine antimoniate.
We conducted an observational retrospective study to identify factors associated with prolongation of corrected QT (QTc) interval during treatment of American tegumentary leishmaniasis with meglumine antimoniate. A group of 108 patients with normal ECG before treatment were included. Thirty-one patients (29%) developed increase of QTc interval beyond 0.44s in the second ECG performed after an average of (mean+/-S.D.) 12.6+/-4.9 days. After univariate and multivariate analysis, the age was associated with prolonged QTc interval, and the use of angiotensin-converting enzyme (ACE) inhibitors demonstrated a protective factor. These results identify elderly as a risk factor to develop prolonged QTc due to antimonial therapy (odds ratio: 1.1; 95% confidence interval: 1.01-1.12), and suggest that use of ACE inhibitors is a possible cardioprotective agent (odds ratio: 0.3; 95% confidence interval: 0.003-0.34). Further studies using prospective methodology are necessary to define the role of ACE inhibitors as prophylactic agent in high-risk patients.
Rodrigues
Alex Miranda
AM
Master in Health Sciences, School Medical Sciences, Federal University of Mato Grosso, Av. Fernando Corrêa da Costa s/n, Coxipó, 78060-900 Cuiabá, MT, Brazil. gsveredas@brturbo.com.br
Hueb
Márcia
M
Nery
Andréia Ferreira
AF
Fontes
Cor Jesus Fernandes
CJ
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D000818:Animals; D000981:Antiprotozoal Agents / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000494:pharmacology; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D004347:Drug Interactions; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007891:Leishmania / Q000254:growth & development*; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy*; D008297:Male; D008536:Meglumine / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D000077485:Meglumine Antimoniate; D015999:Multivariate Analysis; D009942:Organometallic Compounds / Q000009:adverse effects / Q000037:antagonists & inhibitors / Q000627:therapeutic use*; D012189:Retrospective Studies
D000806:Angiotensin-Converting Enzyme Inhibitors; D000981:Antiprotozoal Agents; D002316:Cardiotonic Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate