TY - JOUR
T1 - QT and QT dispersion intervals in long-standing and moderately active rheumatoid arthritis
T2 - results from a multicentre cross-sectional study
AU - Erre, Gian Luca
AU - Piras, Alessandra
AU - Piga, Matteo
AU - Fedele, Anna L.
AU - Mangoni, Arduino A.
AU - Lazzerini, Pietro E.
AU - Gremese, Elisa
AU - Mathieu, Alessandro
AU - Ferraccioli, Gianfranco
AU - Passiu, Giuseppe
AU - Saba, Pier S.
AU - EDRA study group.
AU - Mura, Silvia
AU - Cadoni, Maria
AU - Longu, Maria
AU - Taras, Loredana
AU - Piras, Marco
AU - Cangemi, Ignazio
AU - Dessi, Martina
AU - Fadda, Maria
AU - Pietro, Masia
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Objective To define the prevalence of prolonged QT interval and QT dispersion (QTd) in rheumatoid arthritis (RA) patients and in a control population. Methods QT interval corrected by Bazett's formula (QTc) was calculated from standard 12-lead ECGs in 963 subjects free of previous cardiovascular events (646 RA patients and 317 controls strictly matched for age, sex and cardiovascular risk factors). Results RA patients (59.6±9.6 years, 68.1 % females) had a long mean disease duration (10.6 years) and moderate disease activity (DAS28=3.68±1.23). QTc was 5 msec longer in RA patients than in controls (412±9 vs. 407±28 msec,p=0.013). However, the prevalence of QTc prolongation in RA patients and controls was not significantly different (5.3% vs. 6.3%, p=0.50). On the contrary, RA patients had a significantly greater QTd (42±26 vs. 35±18 msec, p<0.,001) and a higher prevalence of increased QTd (33.3% vs. 18.3%,p<0.001) than controls. Furthermore, RA was independently associated to increased QTd [OR(95%CI)= 2.21(1.58-3.,08), p=0..0001 J. In the RA population, male gender and older age were independently associated with a higher prevalence of prolonged QTd. Conclusion In this cohort of long-standing and moderately active RA patients, RA showed longer QTc but similar prevalence of prolonged QTc and an increased QTd with a 1.8-fold higher prevalence of increased QTd than the control population. Further studies in larger prospective cohorts are warranted to investigate whether QTd prolongation predicts sudden cardiac death and other adverse cardiovascular outcomes in RA.
AB - Objective To define the prevalence of prolonged QT interval and QT dispersion (QTd) in rheumatoid arthritis (RA) patients and in a control population. Methods QT interval corrected by Bazett's formula (QTc) was calculated from standard 12-lead ECGs in 963 subjects free of previous cardiovascular events (646 RA patients and 317 controls strictly matched for age, sex and cardiovascular risk factors). Results RA patients (59.6±9.6 years, 68.1 % females) had a long mean disease duration (10.6 years) and moderate disease activity (DAS28=3.68±1.23). QTc was 5 msec longer in RA patients than in controls (412±9 vs. 407±28 msec,p=0.013). However, the prevalence of QTc prolongation in RA patients and controls was not significantly different (5.3% vs. 6.3%, p=0.50). On the contrary, RA patients had a significantly greater QTd (42±26 vs. 35±18 msec, p<0.,001) and a higher prevalence of increased QTd (33.3% vs. 18.3%,p<0.001) than controls. Furthermore, RA was independently associated to increased QTd [OR(95%CI)= 2.21(1.58-3.,08), p=0..0001 J. In the RA population, male gender and older age were independently associated with a higher prevalence of prolonged QTd. Conclusion In this cohort of long-standing and moderately active RA patients, RA showed longer QTc but similar prevalence of prolonged QTc and an increased QTd with a 1.8-fold higher prevalence of increased QTd than the control population. Further studies in larger prospective cohorts are warranted to investigate whether QTd prolongation predicts sudden cardiac death and other adverse cardiovascular outcomes in RA.
KW - rheumatoid arthritis
KW - QT dispersion
KW - QT prolongation
KW - arrhythmias
KW - electrocardiography
UR - http://www.scopus.com/inward/record.url?scp=85085534123&partnerID=8YFLogxK
M3 - Article
C2 - 31498064
AN - SCOPUS:85085534123
VL - 38
SP - 516
EP - 522
JO - Clinical and Experimental Rheumatology
JF - Clinical and Experimental Rheumatology
SN - 0392-856X
IS - 3
ER -