Prevalence and associated factors of resting electrocardiogram abnormalities among systemic lupus erythematosus patients without cardiovascular disease.
BACKGROUND
Electrocardiogram (ECG) cardiovascular disease (CVD) abnormalities (ECG-CVD) are predictive of subsequent CVD events in the general population. Systemic lupus erythematosus (SLE) patients are vulnerable to CVD. We aimed to determine the prevalence of ECG-CVD in SLE patients and to examine the risk factors associated with ECG-CVD.


METHODS
A 12-lead resting supine ECG was performed on consecutive adult patients attending the clinic. One cardiologist interpreted the ECGs. ECG-CVD were defined as the presence of one or more of the following 4 elements (ECG-4): ST-segment and/or T-wave abnormalities, left ventricular hypertrophy (LVH), left axis deviation (LAD), left bundle branch block (LBBB) and right bundle branch block (RBBB). ECG-5 included the same elements as ECG-4 and the Q-wave. Repeated measurement data were created and the associations between ECG-4/ECG-5 and demographics were evaluated with univariate and multivariate Cox regression models.


RESULTS
Of 487 SLE patients, 104 (21.4%) and 118 (24.2%) patients had one or more of the ECG-4 and ECG-5 elements, respectively. A higher prevalence of ECG-CVD was found in patients with a longer SLE disease duration, and the burden of ECG-CVD elements increased with age. Increased age, active SLE disease, and damage were associated with ECG4 and ECG-5, while treatment of hyperlipidemia was protective.


CONCLUSIONS
A high prevalence of ECG-4 (21.4%) and ECG-5 (24.2%) was found in this SLE cohort. Controlling SLE disease activity is important since it was associated with ECG-4 and ECG-5. Early identification of ECG-4 and ECG-5 in SLE patients might allow for better stratification and risk management.
Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, EW, 1-412, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
Hanan
H
Al Rayes
Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada.
Paula J
PJ
Harvey
Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, EW, 1-412, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.|Toronto Western Research Institute, University of Toronto, Toronto, Ontario, Canada.
Dafna D
DD
Gladman
Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, EW, 1-412, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
Jiandong
J
Su
Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, EW, 1-412, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.
Arthy
A
Sabapathy
Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, EW, 1-412, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada.|Toronto Western Research Institute, University of Toronto, Toronto, Ontario, Canada.
Murray B
MB
Urowitz
Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, University of Toronto, EW, 1-412, 399 Bathurst Street, Toronto, Ontario, M5T 2S8, Canada. zahi.touma@uhn.ca.
Zahi
Z
Touma
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models
Cardiovascular disease; Electrocardiogram; Systemic lupus erythematosus