The Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice

Objective: To assess the prevalence of QTc prolongation in both non-diabetic and diabetic patients on TKIs. Some TKIs have been reported to cause QTc prolongation, which is prevalent in diabetes. However, there is no Risk Evaluation and Mitigation Strategy using series ECG to monitor those patients....

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Autores principales:	Zhongju Lu, Ying Luu, Jack Ip, Imran Husain, Michael Lu, Chang-Kyung Kim, Peng Yang, David Chu, Richard Lin, Ira Cohen, Alan Kaell
Formato:	article
Lenguaje:	EN
Publicado:	Taylor & Francis Group 2021
Materias:	qtc prolongation torsade’s de pointes (tdp) tyrosine kinase inhibitors (tkis) cancer treatment diabetes Internal medicine RC31-1245
Acceso en línea:	https://doaj.org/article/20bfe2a793834e6c83b9085c1c5d4940
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spelling	oai:doaj.org-article:20bfe2a793834e6c83b9085c1c5d49402021-11-17T14:21:57ZThe Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice2000-966610.1080/20009666.2021.1978652https://doaj.org/article/20bfe2a793834e6c83b9085c1c5d49402021-11-01T00:00:00Zhttp://dx.doi.org/10.1080/20009666.2021.1978652https://doaj.org/toc/2000-9666Objective: To assess the prevalence of QTc prolongation in both non-diabetic and diabetic patients on TKIs. Some TKIs have been reported to cause QTc prolongation, which is prevalent in diabetes. However, there is no Risk Evaluation and Mitigation Strategy using series ECG to monitor those patients. Methods: Patients taking TKIs, with two ECGs recorded between 1 January 2010 and 31 December 2017 were selected from the electronic database. The QTc duration >450 ms was determined as prolonged. Percentage of QTc prolongation on participants were compared using Chi-Square test. Results: This study included 313 patients (age 66.1 ± 0.8 years and 57.5% are female) taking TKIs. In non-Diabetic patients, the prevalence of QTc prolongation is 19.1% (n = 253) before and 34.8% (n = 253) after treatment with TKIs (p < 0.001), respectively. In diabetic patients, the prevalence of QTc prolongation is 21.7% (n = 60) before and 40% (n = 60) after treatment with TKIs (p = 0.03), respectively. In addition, we examined the effect of modifying risk factors for cardiovascular disease (CVD) on the prevalence of QTc prolongation caused by TKIs. In non-diabetic patients, the prevalence of QTc prolongation is 33.3% (n = 57) before and 34.2% (n = 196) after risk factors modification (p = 0.91), respectively. In diabetic patients, the prevalence of QTc prolongation is 50% (n = 24) before and 33.3% (n = 36) after risk factors modification (p = 0.20), respectively. Conclusion: Use of TKIs is associated with a significantly increased risk of QTc prolongation for patients, particularly when patients are diabetic. Modification of risk factors for CVD does not significantly affect the prevalence of QTc prolongation caused by TKIs.Zhongju LuYing LuuJack IpImran HusainMichael LuChang-Kyung KimPeng YangDavid ChuRichard LinIra CohenAlan KaellTaylor & Francis Grouparticleqtc prolongationtorsade’s de pointes (tdp)tyrosine kinase inhibitors (tkis)cancer treatmentdiabetesInternal medicineRC31-1245ENJournal of Community Hospital Internal Medicine Perspectives, Vol 11, Iss 6, Pp 799-807 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	qtc prolongation torsade’s de pointes (tdp) tyrosine kinase inhibitors (tkis) cancer treatment diabetes Internal medicine RC31-1245
spellingShingle	qtc prolongation torsade’s de pointes (tdp) tyrosine kinase inhibitors (tkis) cancer treatment diabetes Internal medicine RC31-1245 Zhongju Lu Ying Luu Jack Ip Imran Husain Michael Lu Chang-Kyung Kim Peng Yang David Chu Richard Lin Ira Cohen Alan Kaell The Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice
description	Objective: To assess the prevalence of QTc prolongation in both non-diabetic and diabetic patients on TKIs. Some TKIs have been reported to cause QTc prolongation, which is prevalent in diabetes. However, there is no Risk Evaluation and Mitigation Strategy using series ECG to monitor those patients. Methods: Patients taking TKIs, with two ECGs recorded between 1 January 2010 and 31 December 2017 were selected from the electronic database. The QTc duration >450 ms was determined as prolonged. Percentage of QTc prolongation on participants were compared using Chi-Square test. Results: This study included 313 patients (age 66.1 ± 0.8 years and 57.5% are female) taking TKIs. In non-Diabetic patients, the prevalence of QTc prolongation is 19.1% (n = 253) before and 34.8% (n = 253) after treatment with TKIs (p < 0.001), respectively. In diabetic patients, the prevalence of QTc prolongation is 21.7% (n = 60) before and 40% (n = 60) after treatment with TKIs (p = 0.03), respectively. In addition, we examined the effect of modifying risk factors for cardiovascular disease (CVD) on the prevalence of QTc prolongation caused by TKIs. In non-diabetic patients, the prevalence of QTc prolongation is 33.3% (n = 57) before and 34.2% (n = 196) after risk factors modification (p = 0.91), respectively. In diabetic patients, the prevalence of QTc prolongation is 50% (n = 24) before and 33.3% (n = 36) after risk factors modification (p = 0.20), respectively. Conclusion: Use of TKIs is associated with a significantly increased risk of QTc prolongation for patients, particularly when patients are diabetic. Modification of risk factors for CVD does not significantly affect the prevalence of QTc prolongation caused by TKIs.
format	article
author	Zhongju Lu Ying Luu Jack Ip Imran Husain Michael Lu Chang-Kyung Kim Peng Yang David Chu Richard Lin Ira Cohen Alan Kaell
author_facet	Zhongju Lu Ying Luu Jack Ip Imran Husain Michael Lu Chang-Kyung Kim Peng Yang David Chu Richard Lin Ira Cohen Alan Kaell
author_sort	Zhongju Lu
title	The Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice
title_short	The Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice
title_full	The Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice
title_fullStr	The Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice
title_full_unstemmed	The Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice
title_sort	risk of qtc prolongation in non-diabetic and diabetic patients taking tyrosine kinase inhibitors (tkis)- a patient safety project at a private oncology practice
publisher	Taylor & Francis Group
publishDate	2021
url	https://doaj.org/article/20bfe2a793834e6c83b9085c1c5d4940
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The Risk of QTc Prolongation in Non-Diabetic and Diabetic Patients Taking Tyrosine Kinase Inhibitors (TKIs)- A Patient Safety Project at a Private Oncology Practice

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