Pattern of antimalaria treatment and risk factors for torsades de pointes in admitted heart failure patients in Lagos-Nigeria
Bibliographic record
Abstract
Background: In a malaria-holoendemic region, concurrent malaria complicating heart failure (HF) occurs; with higher morbidity and increased adverse drug-drug interactions. Aim: To characterise malaria treatment and risk factors of cardio-toxicity among HF patients. Objectives: To characterise the use of anti-malaria agents (AMA), compare risk factors of torsades de pointes (TdP) amongst AMA-users and non-users, and to assess length of hospital stay. Methods: Admitted HF patients were retrospectively studied, and grouped on the basis of malaria treatment. TdP risk factors- advanced age, bradycardia, hypokalemia, and QTc prolongation were compared in the two groups. Results: The 160 HF patients (mean ejection fraction 39.6% ± 12.6%, mean age 54.9 ± 14.6 years) included 82 males (51.3%), with predominant non-ischemic HF. Malaria treatment occurred in 32.5% (52), though diagnosis was presumptive in 48 (92.3%). All (100%) malaria prescriptions were artemisinin-based, but monotherapeutic in 6 (11.4%). Partner-drugs included sulphadoxine-pyrimethamine (SP) 26 (50%), and lumefantrine 7 (13.5%). TdP risk-factors of age 65 years, prolonged QTc, hypokalemia, and bradycardia occurred in 43 (26.9%), 63 (39.4%), 48 (30%), and 8 (5.0%) respectively. Group 1 (AMA treated) and group 2 patients were comparable on all mean values of risk factors. Nevertheless, affected proportions were significantly different for hypokalemia (X2 = 6.1), QTc prolongation (48.1% versus 35.2%, p < .05), and older age (38.5% versus, 21.3%, p < .05%). Conclusion: Though all HF patients similarly demonstrated risks of TdP, univariate analysis indicates a significantly higher proportion in malaria-treated patients; supporting further therapeutic caution in this patient subset.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".