Electrocardiographic Findings in Systemic Lupus Erythematosus: Data From an International Inception Cohort

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Abstract

Objective. To estimate the early prevalence of various electrocardiographic (EKG) abnormalities in patients with systemic lupus erythematosus (SLE) and to evaluate possible associations between repolarization changes (increased corrected QT [QTc] and QT dispersion [QTd]) and clinical and laboratory variables, including the anti-Ro/SSA level and specificity (52 or 60 kd). Methods. We studied adult SLE patients from 19 centers participating in the Systemic Lupus International Collaborating Clinics (SLICC) Inception Registry. Demographics, disease activity (Systemic Lupus Erythematosus Disease Activity Index 2000 [SLEDAI-2K]), disease damage (SLICC/American College of Rheumatology Damage Index [SDI]), and laboratory data from the baseline or first followup visit were assessed. Multivariate logistic and linear regression models were used to asses for any cross-sectional associations between anti-Ro/SSA and EKG repolarization abnormalities. Results. For the 779 patients included, mean +/- SD age was 35.2 +/- 13.8 years, 88.4% were women, and mean +/- SD disease duration was 10.5 +/- 14.5 months. Mean +/- SD SLEDAI-2K score was 5.4 +/- 5.6 and mean +/- SD SDI score was 0.5 +/- 1.0. EKG abnormalities were frequent and included nonspecific ST-T changes (30.9%), possible left ventricular hypertrophy (5.4%), and supraventricular arrhythmias (1.3%). A QTc >= 440 msec was found in 15.3%, while a QTc >= 460 msec was found in 5.3%. Mean +/- SD QTd was 34.2 +/- 14.7 msec and QTd >= 40 msec was frequent (38.1%). Neither the specificity nor the level of anti-Ro/SSA was associated with QTc duration or QTd, although confidence intervals were wide. Total SDI was significantly associated with a QTc interval exceeding 440 msec (odds ratio 1.38 [95% confidence interval 1.06, 1.79]). Conclusion. A substantial proportion of patients with recent-onset SLE exhibited repolarization abnormalities, although severe abnormalities were rare.

Details

Authors
  • Josiane Bourre-Tessier
  • Murray B. Urowitz
  • Ann E. Clarke
  • Sasha Bernatsky
  • Mori J. Krantz
  • Thao Huynh
  • Lawrence Joseph
  • Patrick Belisle
  • Sang-Cheol Bae
  • John G. Hanly
  • Daniel J. Wallace
  • Caroline Gordon
  • David Isenberg
  • Anisur Rahman
  • Dafna D. Gladman
  • Paul R. Fortin
  • Joan T. Merrill
  • Juanita Romero-Diaz
  • Jorge Sanchez-Guerrero
  • Barri Fessler
  • Graciela S. Alarcon
  • Kristjan Steinsson
  • Ian N. Bruce
  • Ellen Ginzler
  • Mary Anne Dooley
  • Gunnar Sturfelt
  • Kenneth Kalunian
  • Manuel Ramos-Casals
  • Michelle Petri
  • Asad Zoma
  • Christian A. Pineau
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Rheumatology and Autoimmunity
Original languageEnglish
Pages (from-to)128-135
JournalArthritis Care and Research
Volume67
Issue number1
Publication statusPublished - 2015
Publication categoryResearch
Peer-reviewedYes