Geraldino-Pardilla Laura, Gartshteyn Yevgeniya, Piña Paloma, Cerrone Marina, Giles Jon T, Zartoshti Afshin, Bathon Joan M, Askanase Anca D
Columbia University, College of Physicians & Surgeons , New York, New York , USA.
Northwestern University , Chicago, Illinois , USA.
Lupus Sci Med. 2016 Dec 16;3(1):e000168. doi: 10.1136/lupus-2016-000168. eCollection 2016.
Cardiovascular disease (CVD) is a leading cause of death in systemic lupus erythematosus (SLE) and in rheumatoid arthritis (RA). Although only explored in one study, ECG non-specific ST-T abnormalities, in addition to corrected QT-interval (QTc) prolongation, were recently reported in an SLE inception cohort. Importantly, these ECG abnormalities are known predictors of CVD mortality in the general population, yet their prevalence in patients with established SLE has not been evaluated.
We cross-sectionally investigated the presence of non-specific ST-T and QTc abnormalities in 50 patients with SLE, predominantly Hispanic and black, without CVD or SLE-related cardiac involvement and compared them with 139 patients with RA without CVD. Demographics, disease-specific characteristics and CVD risk factors were ascertained and adjusted for.
Patients with SLE (mean age 36±13 years, 92% women, 6 years median disease duration, 96% Hispanics and blacks) had a 3.3-fold higher adjusted prevalence of non-specific ST-T abnormalities (56% vs 17%; p <0.0001) compared with RA, despite the older age and higher percentage of men in the RA group. The QTc was 26 ms longer in SLE compared with RA (p=0.002) in the setting of a higher percentage of women, blacks, Hispanics and higher C reactive protein levels in the SLE group.
This study demonstrates a high prevalence of ECG abnormalities in predominantly Hispanic and black patients with SLE. Longitudinal evaluation of the progression to potentially life-threatening arrhythmias and/or cardiovascular events is warranted.
心血管疾病（CVD）是系统性红斑狼疮（SLE）和类风湿关节炎（RA）患者死亡的主要原因。尽管仅有一项研究对此进行了探索，但近期在一个SLE起始队列中报告了除校正QT间期（QTc）延长外，心电图非特异性ST-T异常情况。重要的是，这些心电图异常在普通人群中是已知的CVD死亡预测指标，但其在已确诊SLE患者中的患病率尚未得到评估。
我们对50例主要为西班牙裔和黑人、无CVD或SLE相关心脏受累的SLE患者进行横断面研究，调查其非特异性ST-T和QTc异常情况，并与139例无CVD的RA患者进行比较。确定并调整了人口统计学、疾病特异性特征和CVD危险因素。
SLE患者（平均年龄36±13岁，92%为女性，疾病中位病程6年，96%为西班牙裔和黑人）与RA患者相比，经调整后的非特异性ST-T异常患病率高出3.3倍（56%对17%；p<0.0001），尽管RA组患者年龄较大且男性比例较高。在SLE组女性、黑人、西班牙裔比例更高且C反应蛋白水平更高的情况下，SLE患者的QTc比RA患者长26毫秒（p=0.002）。
本研究表明，在主要为西班牙裔和黑人的SLE患者中，心电图异常的患病率很高。有必要对进展为潜在危及生命的心律失常和/或心血管事件进行纵向评估。
