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Clinical Correlates of QTc Prolongation in Patients with Schizophrenia : A Retrospective Study

조현병 환자에서 QTc 간격연장에 관련되는 요인 : 후향적 연구

  • Lee, Jung Suk (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Park, Jaesub (Department of Psychiatry, National Health Insurance Service Ilsan Hospital) ;
  • Park, Sunyoung (Department of Psychiatry, National Health Insurance Service Ilsan Hospital)
  • 이정석 (국민건강보험 일산병원 정신건강의학과) ;
  • 박재섭 (국민건강보험 일산병원 정신건강의학과) ;
  • 박선영 (국민건강보험 일산병원 정신건강의학과)
  • Received : 2021.01.05
  • Accepted : 2021.03.29
  • Published : 2021.06.30

Abstract

Objectives : QTc prolongation due to antipsychotics is of major concern because it may lead to fatal ventricular arrhythmia such as torsade de pointes. However, few studies have been conducted on QTc prolongation due to antipsychotics, especially in South Korea. This study aimed to investigate how demographic and clinical variables affect QTc interval in patients with schizophrenia. Methods : By retrospectively reviewing medical records, we assessed QTc interval, demographic data and clinical features of 441 (175 males) patients with schizophrenia who admitted to the psychiatric ward of a general hospital. To explore the predictive factors for QTc interval, hierarchical regression analysis was performed with QTc interval as the dependent variable. Results : The mean QTc interval was 417.2±28.4 ms. In the hierarchical regression analysis, the use of short-acting antipsychotic injection was the strongest predictor of the QTc prolongation. Conclusions : This study demonstrated that the use of short-acting antipsychotic injection may affect QTc prolongation in patients with schizophrenia. This result suggests that more attention should be paid to the use of short-acting antipsychotic injection in the treatment of schizophrenia.

연구목적 항정신병약물로 인한 QTc간격연장은 심각한 심실성 부정맥을 초래할 가능성 때문에 주의가 필요한 부작용이다. 하지만 현재까지 국내에서 항정신병약물에 의한 QTc간격연장에 대한 연구는 많지 않았다. 본 연구는 조현병 환자에서 QTc간격연장에 영향을 주는 인구학적 및 임상적 변수를 알아보고자 한다. 방 법 일 병원에 입원치료를 받았던 441명 조현병 환자들의 의무기록을 후향적으로 검토하여 QTc간격과 인구학적 및 임상적 변수들을 파악하였다. QTc간격에 영향을 주는 변수를 알아보기 위해 QTc간격을 종속변수로 하여 위계적 중다회귀분석을 수행하였다. 결 과 평균 QTc간격은 417.2±28.4 ms였다. 위계적 중다회귀분석 결과 항정신병약물 단기작용주사제의 사용이 QTc간격연장의 가장 강한 예측인자였다. 결 론 본 연구는 조현병 환자에서 항정신병약물 단기작용주사제 사용이 QTc간격연장에 영향을 줄 수 있으며 조현병 환자의 치료 시 항정신병약물 단기작용주사제 사용에 보다 주의를 기울여야 함을 시사한다.

Keywords

Acknowledgement

본 연구는 국민건강보험 일산병원의 연구비 지원으로 이루어졌음(NHIMC2019CR004).

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