Phenome‐Wide Association Studies Uncover a Novel Association of Increased Atrial Fibrillation in Male Patients With Systemic Lupus Erythematosus

Barnado, April; Carroll, Robert J.; Casey, Carolyn; Wheless, Lee; Denny, Joshua C.; Crofford, Leslie J.

doi:10.1002/acr.23553

Cited by 24 publications

(24 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study was approved by the Vanderbilt University Institutional review board. We used a previously identified systemic lupus erythematosus (SLE) cohort with matched controls by age, race and gender ( Fig 1 ) [ 21 ]. These SLE cases were identified using previously validated and published algorithms with positive predictive values (PPVs) ≥ 90% [ 22 ].…”

Section: Methodsmentioning

confidence: 99%

Contribution of viral infection to risk for cancer in systemic lupus erythematosus and multiple sclerosis

et al. 2021

Self Cite

View full text Add to dashboard Cite

Patients with autoimmune disorders (AD) have altered cancer risks compared to the general population. Systemic lupus erythematosus and multiple sclerosis lead to a heightened risk for hematological malignancies and decreased risk for breast, ovarian, and prostate malignancies. Often patients with autoimmune disease have dysregulated antiviral immune responses, including against oncogenic viruses. To uncover the relationship between viral incidence and cancer risk in the context of autoimmune disease, we extracted electronic health records (EHR) from Vanderbilt University. ICD-9/10 codes and laboratory values were collected for hematological, lung, anal-vaginal, thyroid, hepatobiliary, bladder, prostate, and breast cancers; and viruses including Epstein Barr virus (EBV), Human papilloma virus (HPV), and Hepatitis A/B/C (Hep). Only viral infections that led to a physician visit or laboratory test were entered into the EMR; therefore, only clinically relevant cases were noted and considered positive in this study. The relationship between virus infection and cancer in an SLE cohort (SLE-cases n = 2,313, and SLE-controls n = 5,702) and an MS cohort (MS-case n = 7,277, MS-control n = 7,277) was examined by multilinear logistic regression. Viral infection was strongly associated with increased risk for cancer overall. SLE and MS patients were more susceptible to all viral infections. MS patients trended toward increased risk for cancers overall, while decreased risk for hormone-based cancers in SLE patients non-significantly reduced their risk for overall cancer. Both SLE and MS patients had increased clinically relevant EBV infection, which was associated with risk for hematological cancers. Preventing viral infections by vaccination may be especially helpful in controlling risk for cancer in SLE and MS patients.

show abstract

Section: Methodsmentioning

confidence: 99%

Contribution of viral infection to risk for cancer in systemic lupus erythematosus and multiple sclerosis

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…11 Class I antiarrhythmic agents are not recommended due to frequent cated by elevated norepinephrine levels could play an etiologic role in a wide range of diseases, including SLE. 26 In general, standard medications for SLE (i.e., glucocorticosteroids 27 and anti-malarial drugs 28 ) often caused tachyarrhythmias and QRS prolongation. However, treatment with chloroquine seems to have a protective effect 29 because it reduces the velocity of the action potential of the cells in the conduction system, prolonging the action potential duration and increasing the refractory period of Purkinje fibers.…”

Section: Sarcoidosismentioning

confidence: 99%

Cardiac Arrhythmias in Autoimmune Diseases

Gawałko

Balsam

Lodziński

et al. 2020

Circ J

View full text Add to dashboard Cite

Autoimmune diseases (ADs) affect approximately 10% of the world's population. Because ADs are frequently systemic disorders, cardiac involvement is common. In this review we focus on typical arrhythmias and their pathogenesis, arrhythmia-associated mortality, and possible treatment options among selected ADs (sarcoidosis, systemic lupus erythematosus, scleroderma, type 1 diabetes, Graves' disease, rheumatoid arthritis, ankylosing spondylitis [AS], psoriasis, celiac disease [CD], and inflammatory bowel disease [IBD]). Rhythm disorders have different underlying pathophysiologies; myocardial inflammation and fibrosis seem to be the most important factors. Inflammatory processes and oxidative stress lead to cardiomyocyte necrosis, with subsequent electrical and structural remodeling. Furthermore, chronic inflammation is the pathophysiological basis linking AD to autonomic dysfunction, including sympathetic overactivation and a decline in parasympathetic function. Autoantibody-mediated inhibitory effects of cellular events (i.e., potassium or L-type calcium currents, M2 muscarinic cholinergic or β1-adrenergic receptor signaling) can also lead to cardiac arrhythmia. Drug-induced arrhythmias, caused, for example, by corticosteroids, methotrexate, chloroquine, are also observed among AD patients. The most common arrhythmia in most AD presentations is atrial arrhythmia (primarily atrial fibrillation), expect for sarcoidosis and scleroderma, which are characterized by a higher burden of ventricular arrhythmia. Arrhythmia-associated mortality is highest among patients with sarcoidosis and lowest among those with AS; there are scant data related to mortality in patients with psoriasis, CD, and IBD.

show abstract

“…Atrial fibrillation occurring at young age has been observed in several autoantibody-associated diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and antiphospholipid syndrome [ 66 , 67 , 68 ]. Among the many self-antigens that have been proposed as potential targets of the self-directed immune responses to the heart [ 69 ], heat shock proteins (HSPs) are of special interest, because changes in cardiac HSP60/65 expression have been observed in patients with AF [ 70 , 71 ] and auto-reactivity to HSPs has been observed patients with periodontal disease [ 72 ].…”

Section: Potential Role Of Autoimmunity In Atrial Fibrillationmentioning

confidence: 99%

Potential Impact of Oral Inflammations on Cardiac Functions and Atrial Fibrillation

et al. 2018

View full text Add to dashboard Cite

Inflammation may be a risk factor for atrial fibrillation (AF). Oral infections frequently lead to chronic inflammation, such as gingivitis, periodontitis, and endodontic lesions. In this narrative review, we consider five basic pathogenic mechanisms that involve oral infections and inflammations in the pathogenesis of AF: (1) low level bacteremia by which oral bacteria enter the blood stream at inflamed sites of the oral cavity and invade the heart; (2) Systemic inflammation induced by inflammatory mediators, which are released from the sites of oral inflammation into the blood stream, affecting cardiac remodeling; (3) autoimmunity against molecular structures expressed in the heart caused by the host immune response to specific components of oral pathogens; (4) potentially arrhythmic effects mediated by activation of the autonomous nervous system triggered by oral inflammations; and (5) arrhythmic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. A number of studies support the involvement of all five mechanisms, suggesting a potentially complex contribution of oral inflammations to the pathogenesis of AF.

show abstract

Phenome‐Wide Association Studies Uncover a Novel Association of Increased Atrial Fibrillation in Male Patients With Systemic Lupus Erythematosus

Cited by 24 publications

References 40 publications

Contribution of viral infection to risk for cancer in systemic lupus erythematosus and multiple sclerosis

Contribution of viral infection to risk for cancer in systemic lupus erythematosus and multiple sclerosis

Cardiac Arrhythmias in Autoimmune Diseases

Potential Impact of Oral Inflammations on Cardiac Functions and Atrial Fibrillation

Contact Info

Product

Resources

About