Abstract
Background
Caffeinated energy drinks may trigger serious cardiac effects. The aim of this study
was to determine the cardiovascular effects of caffeinated energy drink consumption
in patients with familial long QT syndrome (LQTS).
Methods and Results
From 2014–2016, 24 LQTS patients aged 16–50 years were recruited to a randomized,
double-blind, cross-over study of energy drink (ED) versus control (CD) with participants
acting as their own controls (one week washout). The primary study outcome was an
increase in corrected QT interval (QTc) by >20ms. Secondary outcomes were changes in systolic and diastolic blood pressure.
In 24 patients with LQTS (no dropout), mean age was 29 ± 9 years, 13/24 (54%) were female, and 8/24 (33%) were probands. Intention to treat
analysis revealed no significant change in QTc with ED compared with CD (12 ± 28 ms vs 16 ± 27 ms, 3% vs 4%, p = 0.71). The systolic and diastolic blood pressure significantly increased with ED compared
to CD (peak change 7 ± 16 mmHg vs 1 ± 16 mmHg, 6% vs 0.8%, p = 0.046 and 8 ± 10 vs 2 ± 9 mmHg, 11% vs 3% p = 0.01 respectively). These changes correlated with significant increases in serum caffeine
(14.6 ± 11.3 vs 0.5 ± 0.1 μmol/L, p < 0.001) and serum taurine (737 ± 199 vs -59 ± 22 μmol/L, p < 0.001). There were three patients with dangerous QTc prolongation of ≥50ms following
energy drink consumption.
Conclusion
Caffeinated energy drinks have significant haemodynamic effects in patients with LQTS,
especifically an acute increase in blood pressure. Since dangerous QTc prolongation
was seen in some LQTS patients, we recommend caution in young patients with LQTS consuming
energy drinks.
Abbreviations:
LQTS (long QT syndrome), QTc (corrected QT interval), ED (energy drink), CD (control drink), ECG (electrocardiogram)Keywords
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Article info
Publication history
Accepted:
December 5,
2016
Received in revised form:
November 30,
2016
Received:
October 23,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
