POS0507 UNUSUALLY HIGH PREVALENCE OF ATRIAL FIBRILLATION IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: B. Mukerji, F. Wang, R. Markert, V. Mukerji
Journal: Annals of the Rheumatic Diseases (2021)

Background: In rheumatoid arthritis, circulating autoantibodies like anticyclic citrullinated peptides and rheumatoid factor may be present for years prior to symptom onset. In RA, there are high levels of circulating tumor necrosis factors, interleukins, matrix metalloproteinases, growth factors, and adhesion molecules that cause tissue damage 1,2 . This can affect different organs in different ways. It is possible that in the heart, they cause inflammation of cardiac tissue 3,4 . Objectives: This study was conducted to determine if patients with RA, an inflammatory arthritis, and osteoarthritis (OA), a degenerative arthritis, differ in the prevalence of cardiac arrhythmias. Methods: This was a retrospective study. We enrolled 300 consecutive patients, 150 with RA and 150 with OA. Patients were assessed for age, race, gender, body mass index (BMI), smoking status, hypertension (HTN), hyperlipidemia (HLD), diabetes mellitus (DM), cardiovascular disease (CVD), coronary artery disease (CAD), cardiac arrhythmias including conduction abnormalities, cerebrovascular accident (CVA), congestive heart failure (CHF), abdominal aortic aneurysm (AAA), pulmonary embolism (PE), deep vein thrombosis (DVT), and peripheral vascular disease (PVD). RA and OA groups were compared with the chi square test and the Mann-Whitney test. Results: The RA and OA groups did not differ on the demographic characteristics of age or race. The presence of DM was similar in the two groups. The RA group had more women than the OA group (12.7% vs. 5.3%, p=0.026). The OA group had a higher mean BMI (33.1 vs 30.0, p&lt;0.001) and higher prevalence of HLD (78.9% vs 64.6%, p=0.007) and HTN (79.3% vs. 66.7%, p=0.013). RA patients had a higher rate of smoking (70.0% vs 56.7%, p=0.017) and longer duration of smoking (34.3 years vs. 28.2 years, p=0.003). The RA group had a higher prevalence of CVD (58.7% vs. 42.7%, p= 0.006). Further data analysis among CVD showed there was no difference between the two groups for the prevalence of CAD, CHF, CVA, AAA, PVD or DVT/PE. RA patients had a higher prevalence of cardiac arrhythmias (31.3% vs. 12.0%, p&lt;0.001). Among all types of cardiac arrhythmias, no significant difference was found between two groups for the prevalence of supraventricular tachycardia, ventricular arrhythmias, or conduction abnormalities. Patients with RA had a significantly higher prevalence of atrial fibrillation (15.3% vs. 6.0%, p = 0.015). Conclusion: Cardiac arrhythmias occur more frequently in RA patients than in OA patients. Among all the arrhythmias, atrial fibrillation has a significantly higher prevalence in RA patients. References: [1]Maradit-Kremers H, et al. Increased unrecognized coronary heart disease and sudden deaths in rheumatoid arthritis: A population-based cohort study. Arthritis Rheum. 2005; 52: 402-411 [2]Seferovic PM, et al. Cardiac arrhythmias and conduction disturbances in autoimmune rheumatic diseases. Rheumatology. 2006; 45: 39-42 [3]Avina-Zubiets JA, et al. Risk of incident cardiovascular events in patients with rheumatoid arthritis: A met-analysis of observational studies. Ann Rheum Dis 2012; 71: 1524-1529 [4]Lazzerini PE, Capechi L, et al. Systemic Inflammation and arrhythmic risk: Lessons from rheumatoid arthritis. European Heart Journal. 2017; 38: 1717-1727 Disclosure of Interests: None declared