Use of Nonrecommended Drugs in Patients With Brugada Syndrome: A Danish Nationwide Cohort Study
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Use of Nonrecommended Drugs in Patients With Brugada Syndrome : A Danish Nationwide Cohort Study. / Jespersen, Camilla H.B.; Krøll, Johanna; Bhardwaj, Priya; Hansen, Carl Johann; Svane, Jesper; Winkel, Bo G.; Jøns, Christian; Jacobsen, Peter Karl; Haarbo, Jens; Nielsen, Jens Cosedis; Johansen, Jens Brock; Philbert, Berit T.; Riahi, Sam; Torp-Pedersen, Christian; Køber, Lars; Hansen, Jacob Tfelt; Weeke, Peter E.
In: Journal of the American Heart Association, Vol. 12, No. 7, e028424, 2023.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Use of Nonrecommended Drugs in Patients With Brugada Syndrome
T2 - A Danish Nationwide Cohort Study
AU - Jespersen, Camilla H.B.
AU - Krøll, Johanna
AU - Bhardwaj, Priya
AU - Hansen, Carl Johann
AU - Svane, Jesper
AU - Winkel, Bo G.
AU - Jøns, Christian
AU - Jacobsen, Peter Karl
AU - Haarbo, Jens
AU - Nielsen, Jens Cosedis
AU - Johansen, Jens Brock
AU - Philbert, Berit T.
AU - Riahi, Sam
AU - Torp-Pedersen, Christian
AU - Køber, Lars
AU - Hansen, Jacob Tfelt
AU - Weeke, Peter E.
N1 - Funding Information: The project was supported by the Novo Nordisk foundation (Tandem Programme; #31634) and the John and Birthe Meyer foundation. Publisher Copyright: © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2023
Y1 - 2023
N2 - BACKGROUND: Patients with Brugada syndrome (BrS) are recommended to avoid drugs that may increase their risk of arrhythmic events. We examined treatment with such drugs in patients with BrS after their diagnosis. METHODS AND RESULTS: All Danish patients diagnosed with BrS (2006– 2018) with >12 months of follow-up were identified from nationwide registries. Nonrecommended BrS drugs were grouped into drugs to “avoid” or “preferably avoid” according to http://www.brugadadrugs.org. Cox proportional hazards analyses were performed to identify factors associated with any nonrecommended BrS drug use, and logistic regression analyses were performed to examine associated risk of appropriate implantable cardioverter defibrillator therapy, mortality, and a combined end point indicating an arrhythmic event of delayed implantable cardioverter defibrillator implantation, appropriate implantable cardioverter defibrillator therapy, and mortality. During a median follow-up of 6.8 years, 93/270 (34.4%) patients with BrS (70.4% male, median age at diagnosis 46.1 years [interquartile range, 32.6– 57.4]) were treated with ≥1 nonrecommended BrS drugs. No difference in any nonrecommended BrS drug use was identified comparing time before BrS diagnosis (12.6%) with each of the 5 years following BrS diagnosis (P>0.05). Factors associated with any nonrecommended BrS drug use after diagnosis were female sex (hazard ratio [HR]) 1.83 [95% CI, 1.15– 2.90]), psychiatric disease (HR, 3.63 [1.89– 6.99]), and prior use of any nonrecommended BrS drug (HR, 4.76 [2.45– 9.25]). No significant association between any nonrecommended BrS drug use and implantable cardioverter de-fibrillator therapy (n=20/97, odds ratio [OR], 0.7 [0.2– 2.4]), mortality (n=10/270, OR, 3.4 [0.7–19.6]), or the combined end point (n=38/270, OR, 1.7 [0.8– 3.7]) was identified. CONCLUSIONS: One in 3 patients with BrS were treated with a nonrecommended BrS drug after BrS diagnosis, and a BrS diagnosis did not change prescription patterns. More awareness of nonrecommended drug use among patients with BrS is needed.
AB - BACKGROUND: Patients with Brugada syndrome (BrS) are recommended to avoid drugs that may increase their risk of arrhythmic events. We examined treatment with such drugs in patients with BrS after their diagnosis. METHODS AND RESULTS: All Danish patients diagnosed with BrS (2006– 2018) with >12 months of follow-up were identified from nationwide registries. Nonrecommended BrS drugs were grouped into drugs to “avoid” or “preferably avoid” according to http://www.brugadadrugs.org. Cox proportional hazards analyses were performed to identify factors associated with any nonrecommended BrS drug use, and logistic regression analyses were performed to examine associated risk of appropriate implantable cardioverter defibrillator therapy, mortality, and a combined end point indicating an arrhythmic event of delayed implantable cardioverter defibrillator implantation, appropriate implantable cardioverter defibrillator therapy, and mortality. During a median follow-up of 6.8 years, 93/270 (34.4%) patients with BrS (70.4% male, median age at diagnosis 46.1 years [interquartile range, 32.6– 57.4]) were treated with ≥1 nonrecommended BrS drugs. No difference in any nonrecommended BrS drug use was identified comparing time before BrS diagnosis (12.6%) with each of the 5 years following BrS diagnosis (P>0.05). Factors associated with any nonrecommended BrS drug use after diagnosis were female sex (hazard ratio [HR]) 1.83 [95% CI, 1.15– 2.90]), psychiatric disease (HR, 3.63 [1.89– 6.99]), and prior use of any nonrecommended BrS drug (HR, 4.76 [2.45– 9.25]). No significant association between any nonrecommended BrS drug use and implantable cardioverter de-fibrillator therapy (n=20/97, odds ratio [OR], 0.7 [0.2– 2.4]), mortality (n=10/270, OR, 3.4 [0.7–19.6]), or the combined end point (n=38/270, OR, 1.7 [0.8– 3.7]) was identified. CONCLUSIONS: One in 3 patients with BrS were treated with a nonrecommended BrS drug after BrS diagnosis, and a BrS diagnosis did not change prescription patterns. More awareness of nonrecommended drug use among patients with BrS is needed.
KW - adverse drug events
KW - BrS
KW - pharmacotherapy
KW - ventricular arrhythmia
U2 - 10.1161/JAHA.122.028424
DO - 10.1161/JAHA.122.028424
M3 - Journal article
C2 - 36942759
AN - SCOPUS:85152159310
VL - 12
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 7
M1 - e028424
ER -
ID: 344709800