Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with general population: a register-based study from Sweden

Bengtsson, Karin; Forsblad‐d’Elia, Helena; Lie, Elisabeth; Klingberg, Eva; Dehlin, Mats; Exarchou, Sofia; Lindström, Ulf; Askling, Johan; Jacobsson, Lennart

doi:10.1136/annrheumdis-2017-212189

Cited by 45 publications

(62 citation statements)

References 38 publications

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“…[4][5][6] However, as for heart comorbidities, valvular heart disease was not mentioned in the ASAS-COMOSPA study, while it has been reported to be associated with SpA in a number of recent studies, based both on epidemiology and pathology. [7][8][9] As for risk factors for cardiovascular diseases, hyperuricaemia was not included as well, while uric acid has also been proven to be related to cardiovascular disease in the recent years. [10][11][12][13] Since there are still some comorbidities and risk factors to be evaluated, we proposed a research to include valvular heart disease as a comorbidity of SpA and hyperuricaemia as a risk factor of cardiovascular disease among patients with SpA.…”

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confidence: 99%

Prevalence of comorbidities and risk factors in spondyloarthritis: results of a cross-sectional study

et al. 2020

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confidence: 99%

Prevalence of comorbidities and risk factors in spondyloarthritis: results of a cross-sectional study

et al. 2020

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“…Patients with AS have a twofold increased risk in second/third‐degree atrioventricular block and pacemaker implantation compared with the general population . Furthermore, male patients are more likely to have conduction disturbances.…”

Section: Discussionmentioning

confidence: 99%

“…Ankylosing spondylitis (AS) increases the risk of various cardiac manifestations, specifically conduction disturbances, aortic regurgitation, and coronary artery disease . Although the prevalence of conduction disturbances ranges from 5% to 33%, complete atrioventricular block is quite rare .…”

Section: Introductionmentioning

confidence: 99%

Transient severe conduction disturbances associated with ankylosing spondylitis

Ikeoka

Nishikawa

Sakakibara

et al. 2019

Journal of Arrhythmia

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A 46‐year‐old man presented with advanced and complete atrioventricular block. He was diagnosed with human leukocyte antigen‐B27‐positive ankylosing spondylitis (AS) and treated with nonsteroidal anti‐inflammatory drugs for AS. The severe atrioventricular block spontaneously improved and resolved after 3 months of therapy. Sequential cardiac magnetic resonance imaging demonstrated transient myocardial high‐intensity signals in the basal septum close to the membranous portion of the septum. A pacemaker was not needed because of the reversible atrioventricular block.

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“…A few large register-based studies, all lacking individual AS characteristics of the included patients, show an increased risk of aortic valve disease, atrioventricular block (AVB) and pacemaker implantation in patients with AS compared with the general population 4 8 9. Else, the majority of previous studies of conduction disturbances or aortic regurgitation in AS are cross-sectional or historical cohort studies 3 10–19.…”

Section: Introductionmentioning

confidence: 99%

Cardiac conduction disturbances in patients with ankylosing spondylitis: results from a 5-year follow-up cohort study

et al. 2019

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ObjectivesTo describe electrocardiographic (ECG) development in patients with ankylosing spondylitis (AS) and identify associations between baseline characteristics and cardiac conduction disturbances (CCD) at 5-year follow-up.MethodsIn a longitudinal cohort study, 172 patients (54% men, mean age (SD) of 50 (13) years at baseline) with AS underwent ECG, physical examination, questionnaires and laboratory testing at baseline and at 5-year follow-up. Descriptive statistics and univariate and age- and sex-adjusted logistic regression analyses were used. CCD included both atrioventricular and intraventricular blocks.ResultsTwenty-three of the 172 patients (13.4%) had a CCD at follow-up. Eight patients had developed a new CCD and eight had normalised their ECG. In the age- and sex-adjusted analyses, CCD at baseline (OR 24.8, 95% CI 7.3 to 84.5), male sex (OR 6.4, 95% CI 2.0 to 20.8), history of anterior uveitis (OR 4.4, 95% CI 1.3 to 14.5), higher ASDAS-CRP (OR 2.3, 95% CI 1.3 to 4.0), greater waist circumference (OR 1.3, 95% CI 1.1 to 1.6, per 5 cm), and medication with antiplatelets (OR 7.0, 95% CI 1.5 to 31.8) and beta-blockers (OR 3.4, 95% CI 1.0 to 11.5) were associated with a CCD at follow-up. Higher age and longer symptom duration were highly correlated and were both associated with a CCD at follow-up.ConclusionsThe presence of CCD in AS is in part dynamic and associated with both AS and non-AS characteristics. Our results suggest that patients especially prone to present with CCDs are older men with a previous CCD, longer symptom duration, higher AS disease activity, a history of anterior uveitis and medication reflecting cardiovascular disease.

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Risk of cardiac rhythm disturbances and aortic regurgitation in different spondyloarthritis subtypes in comparison with general population: a register-based study from Sweden

Abstract: Patients with SpA are at increased risk of aortic regurgitation, cardiac rhythm disturbances and, as a probable consequence, also PM. Particularly for AF, the most common arrhythmia, increased caution is warranted, whereas AV block should be looked for especially in men with AS or uSpA.

Cited by 45 publications

References 38 publications

Prevalence of comorbidities and risk factors in spondyloarthritis: results of a cross-sectional study

Prevalence of comorbidities and risk factors in spondyloarthritis: results of a cross-sectional study

Transient severe conduction disturbances associated with ankylosing spondylitis

Cardiac conduction disturbances in patients with ankylosing spondylitis: results from a 5-year follow-up cohort study

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