Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
The Key Laboratory of Major Autoimmune Diseases, Anhui Medical University, Hefei, Anhui, China.
Immunol Invest. 2022 May;51(4):1095-1107. doi: 10.1080/08820139.2021.1884091. Epub 2021 Feb 10.
Atrial fibrillation (AF) is the most common cardiac arrhythmia contributing to stroke and sudden cardiac death. Numbers of studies indicated that patients with inflammatory arthritis have an increased risk of AF. The present study aims to assess the risk of AF in inflammatory arthritis patients.
We systematically searched cohort studies regarding the risk of AF in patients with rheumatoid arthritis, or spondyloarthritis through PubMed, Web of Science, Cochrane Library, Clinical Trials Registry, and China National Knowledge from inception to August 1, 2019. Meta-analysis was performed using fixed effect model, estimating both crude and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs). Subgroup analysis and meta-regression based on geographic characteristics, comorbidities, and medication use were conducted to explore the source of heterogeneity.
Literature search identified 388 potentially relevant studies, and five studies containing seven cohorts of rheumatoid arthritis or spondyloarthritis were included in the meta-analysis. The AF risk of inflammatory arthritis patients was significantly increased compared with health controls (HR = 1.42, 95% CI: 1.36 to 1.49, = 14.17, < .001), and the pooled HR of studies adjusted factor, like demographic characteristics, medications use, and comorbidities, was 1.37 (95% CI: 1.29 to 1.46; Z = 9.82, < .001).
Patients with inflammatory arthritis have increased risk of AF, probably due to the underlying chronic inflammation. Although various confounders have been adjusted like medications use and comorbidities, the risk of AF is still significantly increased in inflammatory arthritis patients.
AF: Atrial fibrillation; AS: Ankylosing spondylitis; CI: Confidence interval; HR: Hazard ratio; NOS: Newcastle-Ottawa scale; NSAIDs: Non-steroid anti-inflammatory drugs; PsA: Psoriatic arthritis; RA: Rheumatoid arthritis; SpA: Spondyloarthritis; TNFi: Tumor necrosis factors inhibitor; uSpA: Undifferentiated spondyloarthritis.
心房颤动（AF）是最常见的心律失常，可导致中风和心源性猝死。多项研究表明，炎症性关节炎患者发生 AF 的风险增加。本研究旨在评估炎症性关节炎患者发生 AF 的风险。
我们通过 PubMed、Web of Science、Cochrane Library、临床试验注册处和中国国家知识基础设施，从建库至 2019 年 8 月 1 日，系统性地检索了关于类风湿关节炎或脊柱关节炎患者发生 AF 风险的队列研究。采用固定效应模型进行荟萃分析，估计未校正和校正后的风险比（HR）及其 95%置信区间（CI）。基于地理特征、合并症和药物使用情况进行亚组分析和荟萃回归，以探讨异质性的来源。
文献检索共确定了 388 篇潜在相关研究，纳入了 5 项研究共 7 个队列的类风湿关节炎或脊柱关节炎。与健康对照组相比，炎症性关节炎患者发生 AF 的风险显著增加（HR=1.42，95%CI：1.36 至 1.49， =14.17， <0.001），且校正了人口统计学特征、药物使用和合并症等因素后，研究的合并 HR 为 1.37（95%CI：1.29 至 1.46；Z=9.82， <0.001）。
炎症性关节炎患者发生 AF 的风险增加，可能与潜在的慢性炎症有关。尽管已经调整了药物使用和合并症等各种混杂因素，但炎症性关节炎患者发生 AF 的风险仍然显著增加。
AF：心房颤动；AS：强直性脊柱炎；CI：置信区间；HR：风险比；NOS：纽卡斯尔-渥太华量表；NSAIDs：非甾体抗炎药；PsA：银屑病关节炎；RA：类风湿关节炎；SpA：脊柱关节炎；TNFi：肿瘤坏死因子抑制剂；uSpA：未分化脊柱关节炎。
