Department of Medicine, Montefiore New Rochelle Hospital, New Rochelle, New York.
Department of Medicine, Rutgers University Medical Center, Newark, New Jersey.
Heart Rhythm. 2021 Sep;18(9):1516-1523. doi: 10.1016/j.hrthm.2021.05.029. Epub 2021 May 26.
Systemic inflammation has been associated with atherosclerotic cardiovascular diseases (ASCVD) and arrhythmia occurrence in rheumatologic conditions such as rheumatoid arthritis. Polymyositis and dermatomyositis (PD) are rare rheumatologic conditions characterized by symmetrical proximal muscle weakness and, in the case of dermatomyositis, cutaneous eruption. Although there is literature associating PD with ASCVD, no population-level studies have analyzed arrhythmia risk in PD.
The purpose of this study was to assess the prevalence of arrhythmia and its subtypes by age and sex in patients with PD and to determine associations between arrhythmia and PD.
This retrospective cohort study included adults for whom hospitalizations had been recorded in the National Inpatient Sample database in the United States between 2016 and 2018. Patients with PD were matched (1:10) by age to patients without PD. Prevalence of arrhythmia was calculated in the 2 groups and compared by sex and age groups. Associations between PD and arrhythmia were determined after adjustment for common arrhythmia risk factors.
From 107,001,355 hospitalizations, 32,085 adults with PD were matched to 320,850 controls. Patients with PD aged <70 years had a higher prevalence of arrhythmia and higher adjusted odds of arrhythmia compared with controls. This increased risk was only seen for supraventricular arrhythmias. Adults with PD had increased odds of in-hospital mortality if they had an arrhythmia diagnosis (odds ratio 3.3; 95% confidence interval 2.5-4.5; P <.001).
We found a higher prevalence and odds of arrhythmias, particularly supraventricular arrhythmias, in young and middle-aged patients with PD compared with matched controls. Arrhythmias were associated with significant mortality among patients with PD.
系统性炎症与动脉粥样硬化性心血管疾病（ASCVD）以及风湿性疾病（如类风湿关节炎）中的心律失常发生有关。多发性肌炎和皮肌炎（PD）是罕见的风湿性疾病，其特征为对称性近端肌无力，且皮肌炎患者会出现皮疹。虽然有文献表明 PD 与 ASCVD 相关，但尚无针对 PD 患者心律失常风险的人群水平研究。
本研究旨在评估 PD 患者心律失常及其亚型的患病率，并按年龄和性别进行分析，并确定心律失常与 PD 之间的关联。
这是一项在美国国家住院患者样本数据库中进行的回顾性队列研究，纳入了 2016 年至 2018 年期间住院的成年人患者。将 PD 患者按年龄与非 PD 患者 1:10 匹配。在两组患者中计算心律失常的患病率，并按性别和年龄组进行比较。在调整常见心律失常危险因素后，确定 PD 与心律失常之间的关联。
在 107,001,355 例住院患者中，有 32,085 例成年 PD 患者与 320,850 例对照者相匹配。年龄<70 岁的 PD 患者心律失常的患病率更高，且调整后的心律失常发生几率高于对照组。这种风险增加仅见于室上性心律失常。如果 PD 患者被诊断出心律失常，其住院期间的死亡率更高（比值比 3.3；95%置信区间 2.5-4.5；P<.001）。
我们发现与匹配对照组相比，年轻和中年 PD 患者心律失常的患病率和发生几率更高，尤其是室上性心律失常。心律失常与 PD 患者的显著死亡率相关。
