Escitalopram-induced QTc prolongation and its relationship with KCNQ1, KCNE1, and KCNH2 gene polymorphisms

Copyright © 2023. Published by Elsevier B.V..

BACKGROUND: Escitalopram can cause prolongation of the QT interval on the electrocardiogram (ECG). However, only some patients get pathological QTc prolongation in clinic. We investigated the influence of KCNQ1, KCNE1, and KCNH2 gene polymorphisms along with clinical factors on escitalopram-induced QTc prolongation.

METHODS: A total of 713 patients prescribed escitalopram were identified and had at least one ECG recording in this retrospective study. 472 patients with two or more ECG data were divided into QTc prolongation (n = 119) and non-prolongation (n = 353) groups depending on the threshold change in QTc of 30 ms above baseline value (∆QTc ≥ 30 ms). 45 patients in the QTc prolongation group and 90 patients in the QTc non-prolongation group were genotyped for 43 single nucleotide polymorphisms (SNPs) of KCNQ1, KCNE1, and KCNH2 genes.

RESULTS: Patients with QTc prolongation (∆QTc ≥ 30 ms) got higher escitalopram dose (10.3 mg) than patients without QTc prolongation (9.4 mg), although no significant relationship was found between QTc interval and escitalopram dose in the linear mixed model. Patients who were older/coronary disease/hypertension or carried with KCNE1 rs1805127 C allele, KCNE1 rs4817668 C allele, KCNH2 rs3807372 AG/GG genotype were significantly at risk for QTc prolongation (∆QTc ≥ 30 ms). Concomitant antipsychotic treatment was associated with a longer QTc interval.

LIMITATIONS: A relatively small sample size and lack of the blood concentration of escitalopram restricted the accurate relationship between escitalopram dose and QTc interval.

CONCLUSION: Our study revealed that KCNQ1, KCNE1, and KCNH2 gene polymorphisms along with clinical factors provide a complementary effect in escitalopram-induced QTc prolongation.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:347

Enthalten in:

Journal of affective disorders - 347(2024) vom: 15. Feb., Seite 399-405

Sprache:

Englisch

Beteiligte Personen:

Chen, Zimu [VerfasserIn]
Xu, Zhi [VerfasserIn]
Gao, Chenjie [VerfasserIn]
Chen, Lei [VerfasserIn]
Tan, Tingting [VerfasserIn]
Jiang, Wenhao [VerfasserIn]
Chen, Bingwei [VerfasserIn]
Yuan, Yonggui [VerfasserIn]
Zhang, Zhijun [VerfasserIn]

Links:

Volltext

Themen:

4O4S742ANY
Clinic factors
ERG1 Potassium Channel
Escitalopram
Journal Article
KCNE1
KCNE1 protein, human
KCNH2
KCNH2 protein, human
KCNQ1
KCNQ1 Potassium Channel
KCNQ1 protein, human
Potassium Channels, Voltage-Gated
QTc
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 08.01.2024

Date Revised 08.02.2024

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.jad.2023.11.084

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM364917261