title: Possible cardioprotective effect of angiotensin-converting enzyme inhibitors during treatment of American tegumentary leishmaniasis with meglumine antimoniate.
abstract: 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.
authors.affiliation: 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
authors.forename: Alex Miranda
authors.initials: AM
authors.lastname: Rodrigues
authors.forename: Márcia
authors.initials: M
authors.lastname: Hueb
authors.forename: Andréia Ferreira
authors.initials: AF
authors.lastname: Nery
authors.forename: Cor Jesus Fernandes
authors.initials: CJ
authors.lastname: Fontes
mesh_terms: 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
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D000981:Antiprotozoal Agents; D002316:Cardiotonic Agents; D009942:Organometallic Compounds; D008536:Meglumine; D000077485:Meglumine Antimoniate