THU0236 Ankylosing spondylitis related factors predict the presence of cardiac conduction disturbances – a swedish longitudinal cohort study. (12th June 2018)

• Record Type: Journal Article
• Authors: Bengtsson, K.; Klingberg, E.; Deminger, A.; Jacobsson, L.T.; Bergfeldt, L.; Forsblad-d'Elia, H.
• Is Part Of: Annals of the rheumatic diseases. Volume 77(2018)Supplement 2
• Page Start: 337
• Page End: 338
• Publication Date: 2018-06-12
• Subjects: Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2018-eular.2240
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Despite a well-known association between ankylosing spondylitis (AS) and cardiac conduction disturbances (from here CCD), it's not clear which factors that predict their presence. Objectives: To describe electrocardiographic (ECG) alterations in a cohort of patients with AS and if AS related factors at baseline predict the presence of CCD at 5 year follow-up. Methods: In total 210 patients diagnosed with AS at 3 rheumatology clinics from Western Sweden participated 2009 in an observational longitudinal cohort study with a planned follow-up after 5 years., At follow-up 2014 physical examination, ECG, questionnaires, laboratory tests and radiographic examinations were repeated in 172 patients (82%). CCD was defined in the presence of AV block I (PQ duration ≥220 ms), AV block Ix (PQ duration 200–219 ms), AV block II-III, right and left bundle branch block (RBBB and LBBB)), left anterior and posterior fascicular block (LAFB and LPFB) and pacemaker. Descriptive statistics and logistic regression analyses were performed in order to find predictors at baseline for the presence of CCD at follow-up. Baseline characteristics with a p-value<0.2 in univariate analyses (dependent variable present CCD (yes=1, no=0)) were included as independent variables in a forward stepwise multiple logistic regression analysis. Results: In total 23 of the 172 patients (13.4%) had CCD at 5 year follow-up. Eight had developed a new CCD out of which 2 had required pacemaker implantation, 3 had a more aggravated CCD, whereas 10 patient had an unchanged and 2 a less pronounced . CCD compared with 2009 CCD and some of the patient characteristics are presented in table 1. (None had LPFB or AV block II-III). According to multiple logistic regression analysis, male sex (Odds ratio (OR) (95% CI) 4.7 (1.1–20.6)), increasing age (OR 1.1 (1.0–1.1) per 1 year), a history of anterior uveitis (OR 6.4 (1.1–36.2)), higher ASDAS-CRP (OR 3.6 (1.6–7.9)) and existing CCD at baseline (OR 42.4 (8.9–202.2)) were predictors for the presence of CCD at follow-up. Data are expressed as mean ±SD or number (%). # Missing data in 13 patients (10 without CCD and 3 with CCD) who did not underwent echocardiography at baseline. DMARDs; disease-modifying anti-rheumatic drugs. ASDAS-CRP; ankylosing spondylitis disease activity score using C-reactive protein. Conclusions: The presence of CCD in AS is dynamic. AS related factors, represented by baseline ASDAS-CRP and a history of anterior uveitis, predicted their presence at 5 year follow-up. Disclosure of Interest: None declared