Electrocardiographic findings in systemic lupus erythematosus: data from an international inception cohort.
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]).


CONCLUSIONS
A substantial proportion of patients with recent-onset SLE exhibited repolarization abnormalities, although severe abnormalities were rare.
University of Montreal Health Center, Montreal, Quebec, Canada.
Josiane
J
Bourré-Tessier
Murray B
MB
Urowitz
Ann E
AE
Clarke
Sasha
S
Bernatsky
Mori J
MJ
Krantz
Thao
T
Huynh
Lawrence
L
Joseph
Patrick
P
Belisle
Sang-Cheol
SC
Bae
John G
JG
Hanly
Daniel J
DJ
Wallace
Caroline
C
Gordon
David
D
Isenberg
Anisur
A
Rahman
Dafna D
DD
Gladman
Paul R
PR
Fortin
Joan T
JT
Merrill
Juanita
J
Romero-Diaz
Jorge
J
Sanchez-Guerrero
Barri
B
Fessler
Graciela S
GS
Alarcón
Kristján
K
Steinsson
Ian N
IN
Bruce
Ellen
E
Ginzler
Mary Anne
MA
Dooley
Ola
O
Nived
Gunnar
G
Sturfelt
Kenneth
K
Kalunian
Manuel
M
Ramos-Casals
Michelle
M
Petri
Asad
A
Zoma
Christian A
CA
Pineau
D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004562:Electrocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D038622:Internationality; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012042:Registries; D055815:Young Adult