Antipsychotics and Old Age Predict QTc Elongation in Acute Hospitalized Psychiatric Patients

Background: comorbidity with cardiovascular disorders and metabolic syndrome influences QTc elongation in psychiatric sufferers, rather than antipsychotic treatment. Female gender and advanced age predict QTc elongation in psychiatric patients, while some studies questioned the impact of antipsychotic treatment. Objective: we hypothesized that female gender, advanced age, metabolic syndrome, smoking, somatic and cardiovascular comorbidities would predict QTc elongation in a sample of 84 persons with severe mental disorders consecutively admitted in the psychiatric ward of Portogruaro Hospital from January to June 2012. Method: all participants to this naturalistic, cross-sectional study were treated with antipsychotics only, antipsychotics plus antidepressants/mood stabilizers or antidepressants/mood stabilizers. The cut-off for prolonged QTc interval was set at 420 ms. Results: statistically significant differences in weight, HDL cholesterol and BMI were found between patients taking antipsychotics only, antipsychotics plus mood stabilizers/antidepressants and mood stabilizers/antidepressants only. Pearson’s positive correlations were found among QTc, history of cardiovascular diseases and mean drug dosage, while inverted correlations appeared among drug dose, total cholesterol, and HDL cholesterol. HDL cholesterol was negatively associated with weight. Correlations among total cholesterol, weight and BMI were negative as well. Linear regression evidenced three predictors of QTc elongation: age, mean antipsychotics dosage and non-cardiovascular somatic comorbidities. In participants older than 50, only drug dosage and weight predicted QTc increment. Conclusion: differently than previous researches, female gender, smoking and cardiovascular comorbidities did not predict QTc elongation, despite a higher proportion of female participants. Further studies will clarify the influence of metabolic syndrome in causing severe electrocardiographic alterations in psychiatric sufferers.