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QT and QT dispersion intervals in long-standing and moderately active rheumatoid arthritis: results from a multicentre cross-sectional study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11; on behalf of the EDRA study group.

  1. UOC di Reumatologia, Dipartimento di Specialità Mediche, Azienda Ospedaliero-Universitaria di Sassari, Italy.
  2. Università degli Studi di Sassari, Italy.
  3. UOC di Reumatologia, Policlinico Universitario di Monserrato, Cagliari, and Università degli Studi di Cagliari, Italy.
  4. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, Italy.
  5. Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia.
  6. Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Italy.
  7. UOC di Reumatologia, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Roma, and Catholic University of the Sacred Heart, Roma, Italy.
  8. UOC di Reumatologia, Policlinico Universitario di Monserrato, Cagliari, and Università degli Studi di Cagliari, Italy.
  9. Catholic University of the Sacred Heart, Roma, Italy.
  10. UOC di Reumatologia, Dipartimento di Specialità Mediche, Azienda Ospedaliero-Universitaria di Sassari, and Università degli Studi di Sassari, Italy.
  11. UOC di Cardiologia Clinica e Interventistica, Azienda Ospedaliero-Universitaria di Sassari, Italy.

CER12416 Submission on line
Full Papers

Rheumatology Article
Rheumatology Article

 

Abstract

OBJECTIVES:
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]. In the RA population, male gender and older age were independently associated with a higher prevalence of prolonged QTd.
CONCLUSIONS:
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.

PMID: 31498064 [PubMed]

Received: 12/05/2019 - Accepted : 15/07/2019 - In Press: 27/08/2019