Fluoroquinolone use and serious arrhythmias: A nationwide case-crossover study. (June 2019)

• Record Type: Journal Article
• Authors: Porta, Lorenzo; Lee, Meng-tse Gabriel; Hsu, Wan-Ting; Hsu, Tzu-Chun; Tsai, Tou-Yuan; Lee, Chien-Chang
• Is Part Of: Resuscitation. Volume 139(2019)
• Page Start: 262
• Page End: 268
• Publication Date: 2019-06
• Subjects: Fluoroquinolone -- Serious arrhythmias -- Case-crossover study; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2019.04.030
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Aim: Fluoroquinolones have been associated with life-threatening ventricular arrhythmias and even sudden cardiac death. We aimed to assess the temporal relationship of fluoroquinolone use and serious arrhythmias via a case-crossover analysis of a large cohort of serious arrhythmias patients. Methods: In a national administrative database, we compare the distributions of fluoroquinolone exposure for the same patient across a 30-day period before the serious arrhythmia event and 5 randomly selected 30-day periods before the serious arrhythmia event. Odds ratios (ORs) and 95% Confidence Intervals (CIs) were estimated using conditional logistic regression analysis. Results: From a total of 2 million participants, 7657 patients with serious arrhythmias were identified. Use of fluoroquinolones within the 30-day period before the event was significantly associated with increased risk for serious arrhythmia (OR:3.03, 95% CI:2.48, 3.71). The risk association was attenuated, but remained significant after adjustment for time-varying confounders (OR:1.48, 95% CI:1.18, 1.86). A consistent increase in risk of serious arrhythmia was observed for all time windows investigated (7 days, 14 days, 30 days, 60 days and 90 days). Conclusions: Exposure to fluoroquinolones was substantially associated with serious arrhythmic events, independent of the temporal proximity of fluoroquinolone prescription.