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Electrocardiographic effect of artemisinin-piperaquine, dihydroartemisinin-piperaquine, and artemether-lumefantrine treatment in falciparum malaria patients. | LitMetric

AI Article Synopsis

  • Artemisinin-based combination therapies (ACTs) like artemisinin-piperaquine (AP), dihydroartemisinin-piperaquine (DP), and artemether-lumefantrine (AL) are the primary treatments for malaria, but their potential cardiotoxic effects are not well-studied.
  • The study analyzed electrocardiographic changes in 89 patients with falciparum malaria who received these three ACTs, measuring the QT interval before and after treatment.
  • Results indicated that all three ACTs caused prolongation of the QT interval, but the differences between the groups were not significant, and none led to harmful heart rhythms like torsades de pointes.

Article Abstract

Introduction: Artemisinin-based combination therapy (ACT), such as artemisinin-piperaquine (AP), dihydroartemisinin-piperaquine (DP), and artemether-lumefantrine (AL), is the first-line treatment for malaria in many malaria-endemic areas. However, we lack a detailed evaluation of the cardiotoxicity of these ACTs. This study aimed to analyze the electrocardiographic effects of these three ACTs in malaria patients.

Methods: We analyzed the clinical data of 89 hospitalized patients with falciparum malaria who had received oral doses of three different ACTs. According to the ACTs administered, these patients were divided into three treatment groups: 27 treated with AP (Artequick), 31 with DP (Artekin), and 31 with AL (Coartem). Electrocardiograms and other indicators were recorded before and after the treatment. The QT interval was calculated using Fridericia's formula (QTcF) and Bazett's formula (QTcB).

Results: Both QTcF and QTcB interval prolongation occurred in all three groups. The incidence of such prolongation between the three groups was not significantly different. The incidence of both moderate and severe prolongation was not significantly different between the three groups. The ΔQTcF and ΔQTcB of the three groups were not significantly different. The intra-group comparison showed significant prolongation of QTcF after AL treatment.

Conclusions: Clinically recommended doses of DP, AL, and AP may cause QT prolongation in some malaria patients but do not cause torsades de pointes ventricular tachycardia or other arrhythmias.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7891559PMC
http://dx.doi.org/10.1590/0037-8682-0536-2020DOI Listing

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