European Heart Journal Advance Access originally published online on July 13, 2005
European Heart Journal 2005 26(17):1809; doi:10.1093/eurheartj/ehi402
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Drug-induced sudden cardiac death: reply
Pharmaco-Epidemiology Unit
Department of Epidemiology and
Biostatistics and Internal Medicine
Erasmus Medical Center
PO Box 1738
3000 DR Rotterdam
The Netherlands
Pharmaco-Epidemiology Unit
Department of Epidemiology and
Biostatistics and Internal Medicine
Erasmus Medical Center
PO Box 1738
3000 DR Rotterdam
The Netherlands
Tel: +31 10 4088229
E-mail address: b.stricker{at}erasmusmc.nl
We would like to thank Dr Haverkamp and colleagues for their interest in our work. In the first analysis, we focused on the association between antipsychotics and sudden cardiac death. We agree that patients with schizophrenia are at higher risk for medical illnesses than people in the general population. Therefore, we adjusted for indication and showed that the risk of sudden cardiac death was also increased in patients receiving antipsychotics for other indications than schizophrenia.1 In addition, we had in our study complete access to the full medical records of all participants, including hospitalizations and specialists information. Therefore, we were able to gather complete information on known risk factors for sudden cardiac death and other co-variates. These risk factors and co-variates were included in our analysis [cerebrovascular and cardiovascular ischaemia (history of myocardial infarction, stroke, and angina pectoris), heart failure, hypertension, diabetes mellitus, arrhythmia, hypercholesterolaemia, smoking, and alcohol abuse] and we feel that we have accounted for many of the factors that might increase the risk of sudden cardiac death. In the second study, we investigated the association between all QTc-prolonging drugs from a website and sudden cardiac death to study their clinical relevance. Indeed, the contribution of antipsychotics to this problem was relatively substantial and therefore we referred to this earlier study.
We fully agree with Dr Haverkamp and colleagues that the role of the treating physician is crucial in weighing risk benefit of the drugs prescribed. It is crucial that the treating physician is aware of the possible adverse effects of the treatment and we do hope that our study will enable the physicians to choose optimal therapy for their patients.
References
- Straus SM, Bleumink GS, Dieleman JP, van der Lei J, t Jong GW, Kingma JH et al. Antipsychotics and the risk of sudden cardiac death. Arch Intern Med 2004;164:1293–1297.
[Abstract/Free Full Text]
CiteULike 
Connotea 
Del.icio.us What's this?
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||