Electrocardiographic findings in systemic lupus erythematosus: Data from an international inception cohort

Josiane Bourré-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 FesslerGraciela S. Alarcón, Kristján Steinsson, Ian N. Bruce, Ellen Ginzler, Mary Anne Dooley, Ola Nived, Gunnar Sturfelt, Kenneth Kalunian, Manuel Ramos-Casals, Michelle Petri, Asad Zoma, Christian A. Pineau

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)128-135
Number of pages8
JournalArthritis Care and Research
Volume67
Issue number1
DOIs
StatePublished - Jan 1 2015

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Systemic Lupus Erythematosus
Electrocardiography
Linear Models
Confidence Intervals
Equidae
Left Ventricular Hypertrophy
Registries
Cardiac Arrhythmias
Logistic Models
Odds Ratio
Demography

ASJC Scopus subject areas

  • Rheumatology

Cite this

Bourré-Tessier, J., Urowitz, M. B., Clarke, A. E., Bernatsky, S., Krantz, M. J., Huynh, T., ... Pineau, C. A. (2015). Electrocardiographic findings in systemic lupus erythematosus: Data from an international inception cohort. Arthritis Care and Research, 67(1), 128-135. https://doi.org/10.1002/acr.22370

Electrocardiographic findings in systemic lupus erythematosus : Data from an international inception cohort. / Bourré-Tessier, Josiane; Urowitz, Murray B.; Clarke, Ann E.; Bernatsky, Sasha; Krantz, Mori J.; Huynh, Thao; Joseph, Lawrence; Belisle, Patrick; Bae, Sang Cheol; Hanly, John G.; Wallace, Daniel J.; Gordon, Caroline; Isenberg, David; Rahman, Anisur; Gladman, Dafna D.; Fortin, Paul R.; Merrill, Joan T.; Romero-Diaz, Juanita; Sanchez-Guerrero, Jorge; Fessler, Barri; Alarcón, Graciela S.; Steinsson, Kristján; Bruce, Ian N.; Ginzler, Ellen; Dooley, Mary Anne; Nived, Ola; Sturfelt, Gunnar; Kalunian, Kenneth; Ramos-Casals, Manuel; Petri, Michelle; Zoma, Asad; Pineau, Christian A.

In: Arthritis Care and Research, Vol. 67, No. 1, 01.01.2015, p. 128-135.

Research output: Contribution to journalArticle

Bourré-Tessier, J, Urowitz, MB, Clarke, AE, Bernatsky, S, Krantz, MJ, Huynh, T, Joseph, L, Belisle, P, Bae, SC, Hanly, JG, Wallace, DJ, Gordon, C, Isenberg, D, Rahman, A, Gladman, DD, Fortin, PR, Merrill, JT, Romero-Diaz, J, Sanchez-Guerrero, J, Fessler, B, Alarcón, GS, Steinsson, K, Bruce, IN, Ginzler, E, Dooley, MA, Nived, O, Sturfelt, G, Kalunian, K, Ramos-Casals, M, Petri, M, Zoma, A & Pineau, CA 2015, 'Electrocardiographic findings in systemic lupus erythematosus: Data from an international inception cohort', Arthritis Care and Research, vol. 67, no. 1, pp. 128-135. https://doi.org/10.1002/acr.22370
Bourré-Tessier J, Urowitz MB, Clarke AE, Bernatsky S, Krantz MJ, Huynh T et al. Electrocardiographic findings in systemic lupus erythematosus: Data from an international inception cohort. Arthritis Care and Research. 2015 Jan 1;67(1):128-135. https://doi.org/10.1002/acr.22370
Bourré-Tessier, Josiane ; Urowitz, Murray B. ; Clarke, Ann E. ; Bernatsky, Sasha ; Krantz, Mori J. ; Huynh, Thao ; Joseph, Lawrence ; Belisle, Patrick ; Bae, Sang Cheol ; Hanly, John G. ; Wallace, Daniel J. ; Gordon, Caroline ; Isenberg, David ; Rahman, Anisur ; Gladman, Dafna D. ; Fortin, Paul R. ; Merrill, Joan T. ; Romero-Diaz, Juanita ; Sanchez-Guerrero, Jorge ; Fessler, Barri ; Alarcón, Graciela S. ; Steinsson, Kristján ; Bruce, Ian N. ; Ginzler, Ellen ; Dooley, Mary Anne ; Nived, Ola ; Sturfelt, Gunnar ; Kalunian, Kenneth ; Ramos-Casals, Manuel ; Petri, Michelle ; Zoma, Asad ; Pineau, Christian A. / Electrocardiographic findings in systemic lupus erythematosus : Data from an international inception cohort. In: Arthritis Care and Research. 2015 ; Vol. 67, No. 1. pp. 128-135.
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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.",
author = "Josiane Bourr{\'e}-Tessier and Urowitz, {Murray B.} and Clarke, {Ann E.} and Sasha Bernatsky and Krantz, {Mori J.} and Thao Huynh and Lawrence Joseph and Patrick Belisle and Bae, {Sang Cheol} and Hanly, {John G.} and Wallace, {Daniel J.} and Caroline Gordon and David Isenberg and Anisur Rahman and Gladman, {Dafna D.} and Fortin, {Paul R.} and Merrill, {Joan T.} and Juanita Romero-Diaz and Jorge Sanchez-Guerrero and Barri Fessler and Alarc{\'o}n, {Graciela S.} and Kristj{\'a}n Steinsson and Bruce, {Ian N.} and Ellen Ginzler and Dooley, {Mary Anne} and Ola Nived and Gunnar Sturfelt and Kenneth Kalunian and Manuel Ramos-Casals and Michelle Petri and Asad Zoma and Pineau, {Christian A.}",
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TY - JOUR

T1 - Electrocardiographic findings in systemic lupus erythematosus

T2 - Data from an international inception cohort

AU - Bourré-Tessier, Josiane

AU - Urowitz, Murray B.

AU - Clarke, Ann E.

AU - Bernatsky, Sasha

AU - Krantz, Mori J.

AU - Huynh, Thao

AU - Joseph, Lawrence

AU - Belisle, Patrick

AU - Bae, Sang Cheol

AU - Hanly, John G.

AU - Wallace, Daniel J.

AU - Gordon, Caroline

AU - Isenberg, David

AU - Rahman, Anisur

AU - Gladman, Dafna D.

AU - Fortin, Paul R.

AU - Merrill, Joan T.

AU - Romero-Diaz, Juanita

AU - Sanchez-Guerrero, Jorge

AU - Fessler, Barri

AU - Alarcón, Graciela S.

AU - Steinsson, Kristján

AU - Bruce, Ian N.

AU - Ginzler, Ellen

AU - Dooley, Mary Anne

AU - Nived, Ola

AU - Sturfelt, Gunnar

AU - Kalunian, Kenneth

AU - Ramos-Casals, Manuel

AU - Petri, Michelle

AU - Zoma, Asad

AU - Pineau, Christian A.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - 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.

AB - 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.

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