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Rapid Communication| Volume 231, P150-154, March 15, 2017

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Cardiovascular Effects of Energy Drinks in Familial Long QT Syndrome: A Randomized Cross-Over Study

  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Belinda Gray
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Cardiology, Royal Prince Alfred Hospital, NSW, Australia

    Sydney Medical School, University of Sydney, NSW, Australia

    Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, NSW, Australia
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Jodie Ingles
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Cardiology, Royal Prince Alfred Hospital, NSW, Australia

    Sydney Medical School, University of Sydney, NSW, Australia

    Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, NSW, Australia
    Search for articles by this author
  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Caroline Medi
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Cardiology, Royal Prince Alfred Hospital, NSW, Australia

    Sydney Medical School, University of Sydney, NSW, Australia

    Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, NSW, Australia
    Search for articles by this author
  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Timothy Driscoll
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    School of Public Health, University of Sydney, NSW, Australia
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Christopher Semsarian
    Correspondence
    Corresponding author at: Centenary Institute, University of Sydney, Locked Bag 6, Newtown, NSW 2042, Australia.
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Cardiology, Royal Prince Alfred Hospital, NSW, Australia

    Sydney Medical School, University of Sydney, NSW, Australia

    Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, NSW, Australia
    Search for articles by this author
  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.

      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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