Racial susceptibility for QT prolongation in acute drug overdoses.
OBJECTIVE
QT prolongation independently predicts adverse cardiovascular events in suspected poisoning. We aimed to evaluate the association between race and drug-induced QT prolongation for patients with acute overdose.


METHODS
This was a cross-sectional observational study at two urban teaching hospitals. Consecutive adult ED patients with acute drug overdose were prospectively enrolled over a two year period. The primary outcome, long-QT, was defined using standard criteria: QTc>470 ms in females and>460 ms in males. The association between race and drug-induced QT prolongation was tested, considering several confounding variables.


RESULTS
In 472 patients analyzed (46% female, mean age 42.3), QT prolongation occurred in 12.7%. Blacks had two-fold increased odds of drug-induced QT prolongation (OR 2.01, CI 1.03-3.91) and Hispanics had 48% decreased odds of drug-induced QT prolongation (OR 0.52, CI 0.29-0.94).


CONCLUSIONS
We found significant racial susceptibility to drug-induced QT prolongation in this large urban study of acute overdoses.
Division of Medical Toxicology, the Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: alex.manini@mountsinai.org.
Alex F
AF
Manini
Cardiology Division, the Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Barry
B
Stimmel
School of Nursing, University of California at San Francisco, CA.
David
D
Vlahov
D000328:Adult; D003430:Cross-Sectional Studies; D062787:Drug Overdose; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D044469:Racial Groups; D012307:Risk Factors
Overdose; QT prolongation; Racial differences