Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Int J Rheum Dis. 2022 Oct;25(10):1097-1106. doi: 10.1111/1756-185X.14403. Epub 2022 Jul 29.
Patients with systemic lupus erythematosus (SLE) might have increased risk of atrial fibrillation (AF) as a result of initiating chronic and systematic inflammation. However, the prevalence of AF in patients with SLE have not been well quantified. The aim of this systematic review and meta-analysis was to collect and identify available clinical data to explore this possible correlation.
Articles were searched based on electronic databases (PubMed, Scopus, ScienceDirect, Cochrane Library, Web of Science). Review Manager 5.4 was used to perform meta-analysis of all selected studies and subgroup analyses (pooled separately by geographical distribution). Pooled risk ratio (RR) and 95% confidence intervals (95% CI) were calculated by random-effect model or fix-effect model.
Six cohort studies were involved in this meta-analysis, including 311 844 participants, 78 134 cases of SLE and 347 883 non-SLE controls. Pooled studies indicated increased risk of AF development in patients with SLE compared to participants without SLE (I = 96%, RR = 1.85; 95% CI: 1.23-2.79; P = .003). Four clinical trials including only European/ American populations were analyzed in subgroups. Heterogeneity analysis showed that I = 9% and there was an increase in the risk of AF development in European/ American patients with SLE (RR = 1.79; 95% CI: 1.61-1.98; P < .001), while in 2 Korean studies, the heterogeneity was 98% and there was no correlation between AF and SLE (RR = 1.81, 95% CI: 0.39-8.43). Five clinical studies were involved in subgroup analysis after excluding the Beak study, with I = 96% and they suggested that SLE increased the risk of AF development (RR = 2.13, 95% CI: 1.42-3.21, P = .002).
This meta-analysis suggested that SLE may be a risk factor for AF development and the results may vary with geographic distribution.
系统性红斑狼疮（SLE）患者可能由于慢性和系统性炎症而增加心房颤动（AF）的风险。然而，SLE 患者中 AF 的患病率尚未得到很好的量化。本系统评价和荟萃分析的目的是收集和确定可用的临床数据，以探讨这种可能的相关性。
根据电子数据库（PubMed、Scopus、ScienceDirect、Cochrane Library、Web of Science）检索文章。使用 Review Manager 5.4 对所有入选研究进行荟萃分析，并进行亚组分析（按地理分布分别汇总）。采用随机效应模型或固定效应模型计算合并风险比（RR）和 95%置信区间（95%CI）。
本荟萃分析纳入了 6 项队列研究，共纳入 311844 名参与者，其中 78134 例 SLE 患者和 347883 例非 SLE 对照。合并研究表明，与无 SLE 参与者相比，SLE 患者发生 AF 的风险增加（I²=96%，RR=1.85；95%CI：1.23-2.79；P=0.003）。对仅包括欧洲/美洲人群的 4 项临床试验进行了亚组分析。异质性分析显示 I²=9%，且欧洲/美洲 SLE 患者发生 AF 的风险增加（RR=1.79；95%CI：1.61-1.98；P<0.001），而在 2 项韩国研究中，异质性为 98%，AF 与 SLE 之间无相关性（RR=1.81，95%CI：0.39-8.43）。在排除 Beak 研究后，有 5 项临床研究纳入了亚组分析，I²=96%，结果表明 SLE 增加了 AF 发生的风险（RR=2.13，95%CI：1.42-3.21，P=0.002）。
本荟萃分析表明，SLE 可能是 AF 发生的危险因素，且结果可能因地理位置分布而有所不同。
