Abstract 16114: Risk Identification of Drug-induced Long QT Syndrome Using a Patient-specific Long QT-JT Risk Score
Our research is focused on the drug-induced Long QT Syndrome (LQTS) and its relationship to the potentially fatal polymorphic ventricular tachycardia, Torsade de Pointes (TdP). It was our objective to develop a quantitative, comprehensive and clinically applicable Long QT-JT risk score to help clinicians in their decision-making process when faced with patients who have complex drug regimens. We have developed a LQTS Score, which quantifies the risk of TdP pertaining to the following patient-specific conditions and risk factors: gender, age, heart rhythm, potassium and magnesium levels, diuretic use, antiarrhythmic use, drug-drug interactions, and QTc interval. Each factor in the algorithm is weighted according to expected contribution towards TdP risk based on available literature and incorporating both pharmacokinetic and pharmacodynamic drug-drug interactions. We assessed the hypothesis that this risk score would give an accurate depiction of clinical risk. In order to do so, we reviewed the literature and extracted clinical information pertaining to 50 published cases of validated and confirmed drug-induced TdP. We subjected these cases to our algorithm and calculated a patient specific risk score. The Long QT-JT Risk Score was greater than 5 in all cases and greater than 10 in 83% of cases. Such strategy can be applied to a large group of individuals to prospectively and objectively identify patients at greater risk of drug-induced TdP. In conclusion, we have developed a comprehensive patient-specific Long QT-JT Score that can dynamically quantify risk of TdP pertaining to the patient’s own risk factors. Patent Pending: USPTO 62338704
Author Disclosures: L.E. Steffen: None. C.H. Knowlton: Employment; Significant; Stock options in TabulaRasa HealthCare. J. Turgeon: Employment; Modest; Stock options in TabulaRasa HealthCare.
- © 2016 by American Heart Association, Inc.