{
  "abstract": "Background and Importance Drug-induced QT interval prolongation is a relevant safety concern. In lung transplant patients, polypharmacy combined with predisposing factors such as hypokalaemia further increases the risk of developing these electrocardiographic alterations.Aim and Objectives The objectives of this study were to evaluate the exposure to drugs with a risk of QT interval prolongation in lung transplant patients and to identify clinical factors associated with increased susceptibility to this alteration.Material and Methods A single-centre, retrospective, observational study was conducted in a tertiary hospital. All patients >18 years who underwent de novo lung transplantation between October 2023 and December 2024 were included, excluding re-transplantations. Variables collected from electronic medical records were: age, sex, indication for transplantation, treatment received, and clinical factors associated with QT risk (female sex, age >65 years, insomnia, thyroid disorders, grapefruit juice intake, hypomagnesaemia, hypokalaemia, hypocalcaemia, obesity). Drugs were classified according to the Arizona Centre for Education and Research on Therapeutics (AZCERT) into high risk (HR), possible risk (PR) and conditional risk (CR). Data were analysed using descriptive statistics.Results Seventy-one patients were included (24 women, 33.8%) with a mean age of 60.4 years (SD 8.2). Main indications were COPD (32, 45.1%), pulmonary fibrosis (19, 26.8%), interstitial lung disease (7, 9.6%) and emphysema (5, 7.1%). Forty-seven patients (66.2%) received ≥1 HR drug, 71 (100%) ≥1 PR drug and 71 (100%) ≥1 CR drug. The most frequent HR drugs were azithromycin (30, 42.3%) and domperidone (22, 31.0%); among PR drugs, tacrolimus (71, 100%); and among CR drugs, amphotericin B (70, 98.6%), pantoprazole (52, 73.2%) and furosemide (41, 57.7%). Polyexposure was common: 24 patients (34%) received ≥2 HR/PR drugs and 48 (68%) ≥3 CR drugs. The most prevalent risk factors were age >65 years (25, 35.2%), female sex (24, 33.8%) and hypomagnesaemia (20, 28.2%).Conclusion and Relevance Lung transplant patients showed high exposure to QT-prolonging drugs, with frequent polyexposure and coexistence of risk factors such as age >65 years, female sex and hypomagnesaemia. This combination increases the likelihood of severe arrhythmias and potentially fatal events. These findings highlight the need for systematic pharmacotherapeutic review and close clinical monitoring, in which hospital pharmacists play a key role in optimising patient safety.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "L Escobar Hernández"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "M Correa Ballester"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "MJ Fernández Megía"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "M Martín Cerezuela"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "M Rodenas Rovira"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "S Zhu"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "B Arnau"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "M Choví Trull"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "E Monte Boquet"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "J García Pellicer"
    },
    {
      "affiliations": [
        "Hospital Universitari I Politècnic La Fe, Hospital Universitari I Politècnic La Fe, Valencia, Spain"
      ],
      "name": "JL Poveda Andrés"
    }
  ],
  "title": "5PSQ-022 Analysis of exposure to QT-prolonging drugs in lung transplant patients",
  "uid": "48106eb1-66ce-53ff-b2e2-f506889e824c"
}