{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T14:30:24Z","timestamp":1793370624651,"version":"4.5.0"},"reference-count":11,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ EBM"],"accepted":{"date-parts":[[2025,12,26]]},"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To map the risk profile of drug classes at the population level by identifying associations between newly prescribed reimbursed drugs and sudden cardiac arrest (SCA), thereby providing a systematic basis for assessing individual drug effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Population-based, matched case-control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Greater Vienna area, Austria, using linked data from the Austrian Healthcare Reimbursement Database and the Vienna Ambulance Service between 2013 and 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 31 330 insured individuals were included from an estimated 14 448 612 person-years at risk. Cases (n=6266) were patients with SCA, each matched 1:4 to controls (n=25 064) without SCA by age, sex and event date. The estimated absolute case risk equals 43.4 per 100 000 person-years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Newly prescribed reimbursed drugs within 4 weeks before the SCA event, classified according to four-digit Anatomical Therapeutic Chemical (ATC) codes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main analyses<\/jats:title>\n                    <jats:p>Associations between newly prescribed drug classes and SCA, estimated using conditional logistic regression and expressed as ORs with 95% CIs, adjusted for comorbidities and concomitant medications prescribed 120\u201329 days before the event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 322 relevant ATC drug classes, 245 were newly prescribed within 28 days prior to the SCA event. Of these, 57 (23%) were significantly associated with SCA. Eight drug classes demonstrated a markedly elevated risk (OR\u226510), including oripavine derivatives (OR 64, 95% CI 8 to 486), other cardiac preparations (OR 22, 95% CI 2 to 204), plain antiandrogens (OR 18, 95% CI 1.2 to 275) and phenylpiperidine derivatives (OR 16, 95% CI 7 to 38). The most frequently prescribed associated drug classes were penicillins with beta-lactamase inhibitors (179 cases; OR 2.17, 95% CI 1.8 to 2.7), pyrazolones (167 cases; OR 2.14, 95% CI 1.7 to 2.7) and adrenergics combined with anticholinergics (130 cases; OR 2.94, 95% CI 2.2 to 3.9).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Numerous outpatient-prescribed drug classes were associated with SCA. This exploratory, population-based analysis provides a systematic map of potential safety signals to inform more detailed pharmaco-epidemiological investigations, in which confounding and causality can be examined more rigorously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjebm-2025-113993","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T18:20:16Z","timestamp":1768933216000},"page":"315-323","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Mapping drug-class associations with sudden cardiac arrest in the outpatient setting: an exploratory population-based case-control analysis"],"prefix":"10.1136","volume":"31","author":[{"given":"Safoura","family":"Sheikh Rezaei","sequence":"first","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Klinische Pharmakologie, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Mittlb\u00f6ck","sequence":"additional","affiliation":[{"name":"Center for Medical Data Science, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2741-6877","authenticated-orcid":false,"given":"Michael","family":"Schwameis","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Notfallmedizin, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Bergmair","sequence":"additional","affiliation":[{"name":"Dachverband der Sozialversicherungstr\u00e4ger, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Holzer","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Notfallmedizin, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Krammel","sequence":"additional","affiliation":[{"name":"Emergency Medical Service Vienna, Wien, Austria"},{"name":"PULS Austrian Cardiac Arrest Awareness Association, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena Sophie","family":"Boegl","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Frauenheilkunde, Klinische Abteilung f\u00fcr Gyn\u00e4kologische Endokrinologie und Reproduktionsmedizin, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne Elisabeth","family":"Merrelaar","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Notfallmedizin, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Buchtele","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Innere Medizin I, Intensivstation13i2, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra Julia","family":"Lipa","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Notfallmedizin, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kogler","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Notfallmedizin, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Herkner","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik f\u00fcr Notfallmedizin, Medizinische Universit\u00e4t Wien, Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"2026103006301202000_31.5.315.1","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-020-01774-9","article-title":"Preventable medication harm across health care settings: a systematic review and meta-analysis","volume":"18","author":"Hodkinson","year":"2020","journal-title":"BMC Med"},{"key":"2026103006301202000_31.5.315.2","unstructured":"World Health Organization, Integrated Health Services (IHS) . 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