Is disease activity associated with QTc interval prolongation in patients with rheumatoid arthritis?
Higher disease activity in rheumatoid arthritis is independently associated with prolonged QTc intervals, highlighting the potential need for ECG monitoring in patients with active disease.
BACKGROUND: Corrected QT (QTc) prolongation is a frequently observed electrocardiogram (ECG) abnormality in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the association between disease activity and QTc interval in patients with RA. METHODS: Data were obtained from the Kyoto University Rheumatoid Arthritis Management Alliance population-based RA cohort. We used a linear model to compare the association between QTc interval and RA-related parameters, including patient characteristics and disease activity assessed using the visual analog scale, C-reactive protein level, erythrocyte sedimentation rate (ESR), disease activity score 28-joint count using ESR (DAS28-ESR), simplified disease activity index (SDAI), clinical disease activity index (CDAI), and health assessment questionnaire (HAQ) score. We also constructed multivariate linear regression models to adjust for confounding effects. RESULTS: The mean QTc interval of 340 patients mean age: 64.7 ± 12.3 years, female: 289 (85%) with ECG data was 426.8 ± 30.7 ms, and the mean disease activity indices were as follows: DAS28-ESR, 2.7 ± 1.1 points; CDAI, 5.0 ± 5.2 points; SDAI, 5.4 ± 5.7 points; and HAQ, 0.61 ± 0.71 points. Linear correlations were observed between the QTc interval and all parameters for disease activity in the univariate analysis. Disease activity indices (CDAI, SDAI, or DAS28-ESR) were independently associated with the QTc interval (all p < 0.0001). CONCLUSIONS: Disease activity is significantly associated with the QTc interval in patients with RA. Attention should be given to ECG abnormalities in patients with RA and progressive disease activity.
Song et al. (Sun,) studied this question.