Use of quinine and mortality-risk in patients with heart failure--a Danish nationwide observational study
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Use of quinine and mortality-risk in patients with heart failure--a Danish nationwide observational study. / Gjesing, Anne; Gislason, Gunnar H; Christensen, Stefan B; Jørgensen, Mads E; Mérie, Charlotte; Norgaard, Mette Lykke; Poulsen, Henrik Enghusen; Gustafsson, Finn; Køber, Lars; Torp-Pedersen, Christian; Andersson, Charlotte.
I: Pharmacoepidemiology and Drug Safety, Bind 24, Nr. 3, 03.2015, s. 310-8.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Use of quinine and mortality-risk in patients with heart failure--a Danish nationwide observational study
AU - Gjesing, Anne
AU - Gislason, Gunnar H
AU - Christensen, Stefan B
AU - Jørgensen, Mads E
AU - Mérie, Charlotte
AU - Norgaard, Mette Lykke
AU - Poulsen, Henrik Enghusen
AU - Gustafsson, Finn
AU - Køber, Lars
AU - Torp-Pedersen, Christian
AU - Andersson, Charlotte
N1 - Copyright © 2015 John Wiley & Sons, Ltd.
PY - 2015/3
Y1 - 2015/3
N2 - PURPOSE: Leg cramps are common in patients with heart failure. Quinine is frequently prescribed in low doses to these patients, but safety of this practice is unknown. We studied the outcomes associated with use of quinine in a nationwide cohort of patients with heart failure.METHODS: Through individual-level-linkage of Danish national registries, we identified patients discharged from first-time hospitalization for heart failure in 1997-2010. We estimated the risk of mortality associated with quinine treatment by time-dependent Poisson regression models.RESULTS: A total of 135 529 patients were included, with 14 510 patients (11%) using quinine at some point. During a median time of follow-up of 989 days (interquartile range 350-2004) 88 878 patients (66%) died. Patients receiving quinine had slightly increased mortality risk, adjusted incidence rate ratio (IRR) 1.04 (95% confidence interval [CI] 1.01 to 1.07). The risks differed according to concomitant β-blocker treatment. For patients treated with both quinine and β-blockers IRR was 1.15 (95% CI 1.09 to 1.21) vs. 0.99 (95% CI 0.96 to 1.03) for patients treated with quinine but not β-blockers. The risks were highest shortly after initiation of therapy: for the first 14 days of treatment IRR was 2.12 (95% CI 1.54 to 2.93) for patients in treatment with β-blockers and 1.17 (95% CI 0.86 to 1.59) for patients not treated with β-blockers.CONCLUSIONS: Use of quinine was common and associated with increased mortality in heart failure, especially if administered together with β-blockers and shortly after treatment initiation. Mechanisms underlying the findings remain to be established.
AB - PURPOSE: Leg cramps are common in patients with heart failure. Quinine is frequently prescribed in low doses to these patients, but safety of this practice is unknown. We studied the outcomes associated with use of quinine in a nationwide cohort of patients with heart failure.METHODS: Through individual-level-linkage of Danish national registries, we identified patients discharged from first-time hospitalization for heart failure in 1997-2010. We estimated the risk of mortality associated with quinine treatment by time-dependent Poisson regression models.RESULTS: A total of 135 529 patients were included, with 14 510 patients (11%) using quinine at some point. During a median time of follow-up of 989 days (interquartile range 350-2004) 88 878 patients (66%) died. Patients receiving quinine had slightly increased mortality risk, adjusted incidence rate ratio (IRR) 1.04 (95% confidence interval [CI] 1.01 to 1.07). The risks differed according to concomitant β-blocker treatment. For patients treated with both quinine and β-blockers IRR was 1.15 (95% CI 1.09 to 1.21) vs. 0.99 (95% CI 0.96 to 1.03) for patients treated with quinine but not β-blockers. The risks were highest shortly after initiation of therapy: for the first 14 days of treatment IRR was 2.12 (95% CI 1.54 to 2.93) for patients in treatment with β-blockers and 1.17 (95% CI 0.86 to 1.59) for patients not treated with β-blockers.CONCLUSIONS: Use of quinine was common and associated with increased mortality in heart failure, especially if administered together with β-blockers and shortly after treatment initiation. Mechanisms underlying the findings remain to be established.
KW - Aged
KW - Aged, 80 and over
KW - Denmark
KW - Female
KW - Follow-Up Studies
KW - Heart Failure
KW - Hospitalization
KW - Humans
KW - Male
KW - Middle Aged
KW - Mortality
KW - Muscle Relaxants, Central
KW - Quinine
KW - Registries
KW - Risk Factors
U2 - 10.1002/pds.3746
DO - 10.1002/pds.3746
M3 - Journal article
C2 - 25656791
VL - 24
SP - 310
EP - 318
JO - Pharmacoepidemiology and Drug Safety
JF - Pharmacoepidemiology and Drug Safety
SN - 1053-8569
IS - 3
ER -
ID: 161629849