{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T19:04:04Z","timestamp":1766689444941,"version":"3.37.3"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T00:00:00Z","timestamp":1643587200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019266","name":"Korea Medical Device Development Fund","doi-asserted-by":"crossref","award":["KMDF_PR_20200901_0095"],"award-info":[{"award-number":["KMDF_PR_20200901_0095"]}],"id":[{"id":"10.13039\/100019266","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003569","name":"Ministry of Food and Drug Safety","doi-asserted-by":"publisher","award":["19182MFDS406"],"award-info":[{"award-number":["19182MFDS406"]}],"id":[{"id":"10.13039\/501100003569","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Drug-induced QT prolongation is one of the most common side effects of drug use and can cause fatal outcomes such as sudden cardiac arrest. This study adopts the data-driven approach to assess the QT prolongation risk of all the frequently used drugs in a tertiary teaching hospital using both standard 12-lead ECGs and intensive care unit (ICU) continuous ECGs. We used the standard 12-lead ECG results (n = 1,040,752) measured in the hospital during 1994\u20132019 and the continuous ECG results (n = 4,835) extracted from the ICU\u2019s patient-monitoring devices during 2016\u20132019. Based on the drug prescription frequency, 167 drugs were analyzed using 12-lead ECG data under the case-control study design and 60 using continuous ECG data under the retrospective cohort study design. Whereas the case-control study yielded the odds ratio, the cohort study generated the hazard ratio for each candidate drug. Further, we observed the possibility of inducing QT prolongation in 38 drugs in the 12-lead ECG analysis and 7 drugs in the continuous ECG analysis. The seven drugs (vasopressin, vecuronium, midazolam, levetiracetam, ipratropium bromide, nifedipine, and chlorpheniramine) that showed a significantly higher risk of QT prolongation in the continuous ECG analysis were also identified in the 12-lead ECG data analysis. The use of two different ECG sources enabled us to confidently assess drug-induced QT prolongation risk in clinical practice. In this study, seven drugs showed QT prolongation risk in both study designs.<\/jats:p>","DOI":"10.1371\/journal.pone.0263117","type":"journal-article","created":{"date-parts":[[2022,1,31]],"date-time":"2022-01-31T18:24:04Z","timestamp":1643653444000},"page":"e0263117","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":8,"title":["Data-driven drug-induced QT prolongation surveillance using adverse reaction signals derived from 12-lead and continuous electrocardiogram data"],"prefix":"10.1371","volume":"17","author":[{"given":"Byung Jin","family":"Choi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yeryung","family":"Koo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae Young","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3127-2071","authenticated-orcid":true,"given":"Hong-Seok","family":"Lim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1635-8376","authenticated-orcid":true,"given":"Dukyong","family":"Yoon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,1,31]]},"reference":[{"issue":"6","key":"pone.0263117.ref001","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1097\/00045391-200311000-00013","article-title":"QT prolongation and fatal arrhythmias: a review of clinical implications and effects of drugs","volume":"10","author":"LX Cubeddu","year":"2003","journal-title":"Am J Ther"},{"issue":"8858","key":"pone.0263117.ref002","doi-asserted-by":"crossref","first-page":"1423","DOI":"10.1016\/0140-6736(93)90879-L","article-title":"QT prolongation and sudden cardiac death in patients with alcoholic liver disease","volume":"341","author":"CP Day","year":"1993","journal-title":"Lancet"},{"issue":"11","key":"pone.0263117.ref003","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1136\/heart.89.11.1363","article-title":"Drug induced QT prolongation and torsades de pointes","volume":"89","author":"YG Yap","year":"2003","journal-title":"Heart"},{"issue":"6","key":"pone.0263117.ref004","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1111\/j.1530-0277.1992.tb00703.x","article-title":"Prolonged QT interval in alcoholic autonomic nervous dysfunction","volume":"16","author":"A Yokoyama","year":"1992","journal-title":"Alcohol Clin Exp Res"},{"key":"pone.0263117.ref005","doi-asserted-by":"crossref","first-page":"1574806","DOI":"10.1155\/2018\/1574806","article-title":"Risk Evaluation of Azithromycin-Induced QT Prolongation in Real-World Practice","volume":"2018","author":"Y Choi","year":"2018","journal-title":"Biomed Res Int"},{"issue":"2","key":"pone.0263117.ref006","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1046\/j.1365-2125.2002.01617.x","article-title":"Non-antiarrhythmic drugs prolonging the QT interval: considerable use in seven countries","volume":"54","author":"F De Ponti","year":"2002","journal-title":"Br J Clin Pharmacol"},{"issue":"8","key":"pone.0263117.ref007","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1177\/2042098618780854","article-title":"Withdrawal of prenylamine: perspectives on pharmacological, clinical and regulatory outcomes following the first QT-related casualty","volume":"9","author":"RR Shah","year":"2018","journal-title":"Ther Adv Drug Saf"},{"issue":"3","key":"pone.0263117.ref008","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/bcp.12201","article-title":"Are women more susceptible than men to drug-induced QT prolongation? Concentration-QTc modelling in a phase 1 study with oral rac-sotalol","volume":"77","author":"B Darpo","year":"2014","journal-title":"Br J Clin Pharmacol"},{"issue":"23","key":"pone.0263117.ref009","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1016\/j.jacc.2009.02.047","article-title":"The scope of coronary heart disease in patients with chronic kidney disease","volume":"53","author":"FG Hage","year":"2009","journal-title":"J Am Coll Cardiol"},{"issue":"2","key":"pone.0263117.ref010","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1177\/0003319707300368","article-title":"QT interval analysis in patients with chronic liver disease: a prospective study","volume":"58","author":"F Kosar","year":"2007","journal-title":"Angiology"},{"issue":"4","key":"pone.0263117.ref011","doi-asserted-by":"crossref","first-page":"e0176222","DOI":"10.1371\/journal.pone.0176222","article-title":"ECG-ViEW II, a freely accessible electrocardiogram database","volume":"12","author":"YG Kim","year":"2017","journal-title":"PLoS One"},{"key":"pone.0263117.ref012","unstructured":"Chesnokov YC, Nerukh D, Glen RC, editors. Individually adaptable automatic QT detector. 2006 Computers in Cardiology; 2006 17\u201320 Sept. 2006."},{"issue":"1","key":"pone.0263117.ref013","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/0002-8703(47)90421-3","article-title":"The duration of the electrical systole, Q-T, in acute rheumatic carditis in children","volume":"33","author":"LM Taran","year":"1947","journal-title":"Am Heart J"},{"issue":"2","key":"pone.0263117.ref014","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.tcm.2017.07.010","article-title":"CredibleMeds.org: What does it offer?","volume":"28","author":"RL Woosley","year":"2018","journal-title":"Trends Cardiovasc Med"},{"key":"pone.0263117.ref015","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.amjcard.2020.09.061","article-title":"The QT Interval in Patients With the Turner Syndrome","volume":"140","author":"NJ Harrahill","year":"2021","journal-title":"Am J Cardiol"},{"issue":"2","key":"pone.0263117.ref016","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s00213-020-05716-4","article-title":"Drug-drug interactions between COVID-19 treatments and antipsychotics drugs: integrated evidence from 4 databases and a systematic review","volume":"238","author":"BO Plasencia-Garcia","year":"2021","journal-title":"Psychopharmacology (Berl)"},{"issue":"11","key":"pone.0263117.ref017","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1016\/j.jacc.2008.12.014","article-title":"AHA\/ACCF\/HRS recommendations for the standardization and interpretation of the electrocardiogram: part IV: the ST segment, T and U waves, and the QT interval: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. 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