만성 조현병 입원환자에서의 QTc 간격 연장과 관련된 요인

초록

Objectives：QTc prolongation is associated with fatal arrhythmias, particularly torsades de pointes and sudden cardiac death. However, little is known regarding the risk factors for QTc prolongation in in-patients with chronic schizophrenia who take antipsychotics. This study aimed to explore the association between QTc and demographic variables, metabolic parameters and prescribed medications in-patients with chronic schizophrenia who take antipsychotics. Methods：We examined 200 in-patients with chronic schizophrenia who were taking antipsychotics in a long-term psychiatric hospital. Demographic and clinical variables, including ECG and prescribed medications, were retrospectively obtained from medical charts. QTc prolongation was defined as increased QTc intervals greater than 450ms in men and 470ms in women. The associations between QTc and other continuous variables were assessed using correlation and regression analyses, and a secondary analysis of interaction effects was performed among significant variables. Results：The prevalence of QTc prolongation inpatients with schizophrenia was 33.1%. After controlling for significant variables, linear regression analysis revealed that QT interval was influenced by a total antipsychotic dose(β= 0.19, p<0.01). There was a significant interaction effect between total antipsychotics dose and cigarette smoking with QTc as the dependent variable(β=-0.36, p<0.01). Conclusion：The total antipsychotics dose is associated with QTc prolongation in a dose-related manner. It is important for psychiatrists to consider various factors when prescribing antipsychotics and to regularly check patients’ ECG.

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