People with type 2 diabetes have twice the risk for sudden cardiac arrest (SCA) if they take some commonly prescribed antibiotic, antipsychotic or prokinetics drugs, or have low fasting blood sugar, according to a new study.
The research was presented at the Annual Meeting of the European Association for the Study of Diabetes in Hamburg, Germany. SCA — when the heart suddenly stops pumping blood — accounts for up to 50% cardiac deaths and 20% of deaths in high-income countries.
A team led by Peter Harms, a researcher at Amsterdam UMC in Amsterdam, The Netherlands, examined 3,919 people who had type 2 diabetes. Some 689 had SCA and 3,230 did not have SCA. The SCA cases occurred between 2010 to 2019. The abstract didn’t share the age of the people studied.
Researchers evaluated clinical measurements like blood pressure and blood glucose, medication use and medical history for five years leading up to the SCA.
Here’s what characteristics were linked to an increased risk of SCA (in people with and without cardiovascular disease):
- History of arrhythmias (68% increased risk of SCA)
- Smoking (40% increased risk of SCA)
- Insulin use (138% increased risk of SCA)
- QTc-prolonging prokinetic medication (66% increased risk of SCA)
Many common drugs, including some prokinetic, antibiotic and antipsychotic medications, are associated with a change in functioning of the heart’s electrical system known as QT-prolongation and are described as being QTc-prolonging. The QTc-prolonging prokinetics include domperidone, while antibiotics include marcolides and fluoroquinolones, and antipsychotics include haloperidol.Prokinetics are medicines for gastrointestinal symptoms.
Doctors are already aware that classic cardiovascular risk factors such as high blood pressure raise the risk of sudden cardiac arrest in people with type 2 diabetes. However, the link with low fasting glucose and antibiotic, antipsychotic and prokinetic medications is less well-known, Harms said.
“Our results underline the need for GPs to be aware of the hazards of too strict glycemic control and the prescription of commonly used antibiotics, antipsychotics and prokinetics,” Harms added.
