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QTc prolongation not inherent in eating disorders

05 Sep 2020

The population-mean heart-rate–corrected QT interval (QTc) in a cohort of patients with eating disorders is normal and varies by subtype, according to a study. Marked QTc prolongation only occurs in the presence of external factors, indicating that QTc prolongation is not intrinsic to eating disorders.

“Anorexia nervosa is associated with a markedly increased risk of sudden cardiac death, but the mechanism has not been elucidated,” they said. “Whether QT prolongation is an intrinsic feature of eating disorders is uncertain because previous studies are limited by small sample size, and extrinsic factors associated with QT prolongation were inconsistently reported.”

In this study, electrocardiogram data were assessed from 1,026 consecutive adults admitted into residential treatment based on subtype: anorexia nervosa (caloric restriction only), anorexia nervosa binge-purge, and bulimia nervosa. Eating disorder not specified were excluded.

The authors performed population-mean Fridericia-corrected QTc and categorized QTc threshold analysis. Multivariable regression was performed, controlling for age, sex, duration of illness, body mass index, hypokalaemia, QTc-prolonging drugs, purging behaviours, and laxatives.

A total of 906 patients were included, among whom the population-mean QTc (424±25) was found to be normal and lowest in the anorexia nervosa subgroup (417.3±22.3; p<0.001 vs other subgroups). Only 11 (1.2 percent) patients had substantial QTc prolongation (QTc >500 ms); all of them had hypokalaemia and received QTc-prolonging medications or laxatives.

Differences in mean QTc across eating disorder subtypes diminished but persisted after controlling for clinically relevant covariates (p=0.048).

Further research is warranted to define the aetiology of sudden death in patients with eating disorders, according to the authors.

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Most Read Articles
Elvira Manzano, 28 Jul 2020
The efficacy and cardiovascular (CV) safety of the SGLT2* inhibitor empagliflozin vs DPP-4** inhibitors and GLP-1*** receptor agonists in real-world patients were demonstrated in two interim analyses of the EMPRISE+ study presented at ADA 2020.
Roshini Claire Anthony, 14 Sep 2020

Patients hospitalized with mild-to-moderate COVID-19 who are on angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) for hypertension should continue these medications, according to primary results of the BRACE CORONA trial presented at ESC 2020.

Tristan Manalac, 09 Jul 2020
Left ventricular assist devices (LVADs) trigger almost immediate favourable metabolic changes in both diabetics and nondiabetics, according to a recent study.
29 Mar 2020
Targeting a low-density lipoprotein cholesterol level <70 mg/dL following an ischaemic stroke of atherosclerotic origin helps to avoid one in four subsequent major vascular events without increasing the risk of intracranial haemorrhage over about 5 years of follow-up, according to data from the Treat Stroke to Target trial.