Min Hong Ki, Kim Hae-Rim, Lee Sang-Heon, Park Sojeong, Park Minae, Hong Yeon Sik, Kim Moon-Young, Park Sung-Hwan, Kang Kwi Young
Division of Rheumatology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, South Korea.
Division of Rheumatology, Department of Internal Medicine, Research Institute of Medical Science, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
Ther Adv Musculoskelet Dis. 2022 Mar 30;14:1759720X221088094. doi: 10.1177/1759720X221088094. eCollection 2022.
To compare the incidences of aortic regurgitation, atrial fibrillation (AF), and atrioventricular (AV) block II-III between radiographic axial spondyloarthritis (r-axSpA) patients and the general population (GP).
National Health Insurance Services data were used. R-axSpA patients ( = 8877) and the age- and sex-matched GP ( = 26,631) were followed from August 2006 to December 2019. Incidence rates and standardized incidence ratios (SIRs) of aortic regurgitation, AF, and AV block II-III were compared between these groups. Ten-year incidence rates and hazard ratios (HRs) were calculated by the Kaplan-Meier method and Cox regression analysis.
Incidence rates of aortic regurgitation, AV block II-III, and AF in the r-axSpA group were 0.42, 0.21, and 4.0 per 1000 person-years (PYs), respectively. In the r-axSpA group, the SIR for aortic regurgitation was highest among 40- to 49-year-old men (4.11). Incidence rates of aortic regurgitation and AF were higher in the r-axSpA group than in the GP group (0.42 0.18 per 1000 PYs 4.00 3.13 per 1000 PYs, both < 0.001, respectively), whereas the difference was insignificant for AV block II-III (0.21 0.14 per 1000 PYs, = 0.222). In multivariate analysis, r-axSpA was associated with a higher hazard (risk) for the development of aortic regurgitation and AF [HR (95% confidence interval) = 2.55 (1.49-4.37) and 1.20 (1.04-1.39), respectively], but the difference was insignificant for AV block II-III [HR (95% confidence interval) = 1.17 (0.59-2.31)].
Compared with the GP, r-axSpA patients are at increased risk of aortic regurgitation and AF, but not AV block II-III. These patients should be carefully monitored for occurrence of aortic regurgitation and AF.
比较影像学轴向性脊柱关节炎（r-axSpA）患者与普通人群（GP）中主动脉瓣关闭不全、心房颤动（AF）和二度至三度房室传导阻滞（AV阻滞）的发生率。
使用国民健康保险服务数据。对8877例r-axSpA患者和年龄及性别匹配的26631例普通人群从2006年8月至2019年12月进行随访。比较两组之间主动脉瓣关闭不全、AF和AV阻滞二度至三度的发病率和标准化发病率比（SIRs）。采用Kaplan-Meier法和Cox回归分析计算十年发病率和风险比（HRs）。
r-axSpA组中主动脉瓣关闭不全、AV阻滞二度至三度和AF的发病率分别为每1000人年0.42、0.21和4.0。在r-axSpA组中，40至49岁男性的主动脉瓣关闭不全SIR最高（4.11）。r-axSpA组中主动脉瓣关闭不全和AF的发病率高于普通人群组（分别为每1000人年0.42对0.18以及4.00对3.13，均P<0.001），而AV阻滞二度至三度的差异无统计学意义（每1000人年0.21对0.14，P=0.222）。多变量分析中，r-axSpA与主动脉瓣关闭不全和AF发生的更高风险相关[HR（95%置信区间）分别为2.55（1.49 - 4.37）和1.20（1.04 - 1.39）]，但AV阻滞二度至三度的差异无统计学意义[HR（95%置信区间）=1.17（0.59 - 2.31）]。
与普通人群相比，r-axSpA患者发生主动脉瓣关闭不全和AF的风险增加，但AV阻滞二度至三度风险未增加。应密切监测这些患者主动脉瓣关闭不全和AF的发生情况。
