QTc interval in anorexia nervosa: a systematic review and meta-analysis

Abstract Background Patients with anorexia nervosa (AN) are at higher risk of sudden cardiac death. Although the underlying aetiology for this association remains unclear. It may be related to prolongation QT interval, which can degenerate into fatal ventricular arrhythmias. However, presence prolonged heart rate-corrected interval (QTc) in AN controversial, and two previous meta-analyses on QTc showed contradictory findings [1,2]. Purpose In systematic review meta-analysis, we aimed evaluate if was associated changes dispersion. Methods MEDLINE, EMBASE COCHRANE databases were systematically searched from inception January 2021. Random-effects meta-analysis meta-regression used. The inclusion criteria (i) confirmed diagnosis AN, (ii) measurement electrocardiogram (iii) peer-reviewed articles. primary endpoint study duration calculated using Bazett (QTcB), Hodges (QTcH), Fridericia (QTcF) Framingham (QTcFr) formulae. secondary endpoints dispersion (QTd) (QTcd). Results 25 eligible studies included 5687 patients (1862 3825 control) (Figure 1: PRISMA diagram). majority female (96.3%) a mean age between 14.3 31.0 years disease ranging 9.1 129.6 months. BMI ranged 13.7 18.5 kg/m2. Pooled analysis did not show significant versus control QTcB (mean difference (MD) MD 4.9ms, 95% CI −3.2, 13.1ms, p=0.23; I2=95%; n=24/25 studies; Figure 2A), QTcH (MD 1.3ms, −8.5, 11.2ms, p=0.79; I2=71%; n=3/25 studies), QTcF 3.1ms, −21.6, 27.7ms, p=0.81; I2=97%; studies). Only reporting QTcFr 15.9ms, 0.0, 31.8ms, p=0.05, I2=65%; n=2/25 2B). QTd QTcd significantly greater than 21.3ms, 10.4, 32.3ms, p=0.0001, I2=94%; 2C 16.9ms, 4.5, 29.3ms, p=0.007 I2=93%; 2D, respectively). Conclusion To best our knowledge, is largest first exploring significance AN. found Bazett, an observed formula. More pronounced (QTd QTcd) also Funding Acknowledgement Type funding sources: None.