Abstract
Background. Given the high prevalence of gastrointestinal disorders among hospitalized pediatric patients and the widespread intravenous administration of gastric acid-suppressive agents such as pantoprazole and famotidine, concerns have been raised about their potential cardiovascular effects. This study was designed to compare the effects of intravenous pantoprazole and famotidine on heart rate and the corrected QT interval (QTc).
Methods. In this prospective analytical cross-sectional study, a total of 122 hospitalized children admitted to Amir Al-Momenin Hospital in Semnan who received either pantoprazole or famotidine were enrolled. Heart rate and QTc were recorded before and after drug administration. To control for baseline values, univariate analysis of covariance was performed using pre-treatment measurements as covariates in SPSS software version 26.0. A P-value of less than 0.05 was considered statistically significant.
Results. After adjustment for baseline values, the adjusted mean post-treatment heart rate was significantly lower in the pantoprazole group compared with the famotidine group (P<0.05). No statistically significant between-group difference was observed in post-treatment QTc values (P=0.061). In within-group analyses, the administration of pantoprazole was associated with a significant reduction in heart rate and a significant prolongation of QTc, whereas no significant changes were observed in the famotidine group.
Conclusion. Intravenous pantoprazole exerts a more pronounced heart rate-lowering effect than famotidine, while no significant difference in QTc was detected between the two groups after adjustment for baseline values.
Practical Implications. Close electrocardiographic monitoring is recommended in pediatric patients receiving intravenous pantoprazole, particularly in the presence of cardiac or electrophysiological risk factors.