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Table 2 Classification of 35 patients with fatal outcome from cardiac origin presumably related to halofantrine (HF) according to the number of predisposing factors to cardiac complication and indication for halofantrine

From: Fatal cardiotoxicity related to halofantrine: a review based on a worldwide safety data base

Number of predisposing factor(s), number of patients (number of children) Details on predisposing factors (underlying cardiac disease, concomitant medication, misuse of HF, etc) Wrong or debatable indication for HF
no predisposing factors, n = 9 (0) Pt # 2, 11§ 12, 16, 17, 18, 20, 31, 33 a* = 1, b* = 2, c* = 1, d* = 2
1 predisposing factor, n = 16 (2) Pt # 1, 30: vibramycine b* = 3, c* = 2
  Pt # 5, 8, 14, 19: chloroquine e* = 1
  Pt # 7: bundle branch block¤  
  Pt # 9, 34: HF taken with food  
  Pt # 13: metronidazole  
  Pt # 21: potassium infusion  
  Pt # 23: unknown severe cardiac valve disease  
  Pt # 24: angina pectoris  
  Pt # 25: ciprofloxacine  
  Pt # 29: mefloquine  
  Pt # 32: HF overdose (45 mg/kg)  
2 predisposing factors, n = 5 (2) Pt # 3: cardiomyopathy¤ + furosemide a* = 1; c* = 1
  Pt # 4: obesity + chloroquine d* = 1; f* = 1
  Pt # 6: tachycardia + mefloquine  
  Pt # 10: severe anaemia and dehydration + amodiaquine  
  Pt # 26: unknown right ventricular arrhythmogenic dysplasia + chloroquine  
3 predisposing factors, n = 5 (1) Pt # 15: cardiac arrhythmia + chloroquine + amodiaquine b*= 2; c* = 2
  Pt # 22: arteriosclerosis and high blood pressure + indapamide + HF taken with food  
  Pt # 27: unknown cardiomyopathy + mefloquine + erythromycin  
  Pt # 28: unknown right ventricular arrhythmogenic dysplasia + chloroquine + probable HF overdose°  
  Pt # 35: tachyarrhythmia¤ + mefloquine + HF overdose (72 mg/kg)  
  1. *: a = no certainty of malaria diagnosis/no blood smear performed (industrialised country);
  2. b = no certainty of malaria diagnosis/no blood smear performed (developing country);
  3. c = no malaria (blood smear negative); d = possible severe malaria; e = severe malaria;
  4. f = P. vivax
  5. ¤: known prior to HF prescription; §actual exposure to HF unsure; ° high HF blood level (see text)