Assessment of the Relationship Between Dose and Number of Effective Used Drugs on on QT Interval in Patients with Lupus

Mostafavi, Amir; Taassoarian, Baharak; Khadir, V A; Abbaszadeh, Sahand; Sanatkar, Seyed Amir; Rafiei, Mohammad

doi:10.5812/semj.83710

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Consistent results were obtained by four subsequent studies, all conducted in SLE patients. Sham et al ( 68 ) reported that mean QTc was longer in SLE subjects with, rather than without circulating anti-Ro/SSA-antibodies, while Mostafavi et al ( 71 ) and Perez-Garcia et al ( 69 ) found that anti-Ro/SSA-antibodies were more commonly detectable and at a higher concentration when SLE patients with QTc prolongation were compared to those with a normal QTc. Moreover, in a study using machine learning in 299 patients with SLE, Hu et al ( 72 ) identified anti-Ro/SSA positivity as one of the most important independent variables associated with QTc prolongation > 450 ms in these subjects.…”

Section: Anti-ro/ssa-associated Long-qt Syndromementioning

confidence: 99%

Anti-Ro/SSA Antibodies and the Autoimmune Long-QT Syndrome

et al. 2021

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Autoimmunity is increasingly recognized as a novel pathogenic mechanism for cardiac arrhythmias. Several arrhythmogenic autoantibodies have been identified, cross-reacting with different types of surface proteins critically involved in the cardiomyocyte electrophysiology, primarily ion channels (autoimmune cardiac channelopathies). Specifically, some of these autoantibodies can prolong the action potential duration leading to acquired long-QT syndrome (LQTS), a condition known to increase the risk of life-threatening ventricular arrhythmias, particularly Torsades de Pointes (TdP). The most investigated form of autoimmune LQTS is associated with the presence of circulating anti-Ro/SSA-antibodies, frequently found in patients with autoimmune diseases (AD), but also in a significant proportion of apparently healthy subjects of the general population. Accumulating evidence indicates that anti-Ro/SSA-antibodies can markedly delay the ventricular repolarization via a direct inhibitory cross-reaction with the extracellular pore region of the human-ether-a-go-go-related (hERG) potassium channel, resulting in a higher propensity for anti-Ro/SSA-positive subjects to develop LQTS and ventricular arrhythmias/TdP. Recent population data demonstrate that the risk of LQTS in subjects with circulating anti-Ro/SSA antibodies is significantly increased independent of a history of overt AD, intriguingly suggesting that these autoantibodies may silently contribute to a number of cases of ventricular arrhythmias and cardiac arrest in the general population. In this review, we highlight the current knowledge in this topic providing complementary basic, clinical and population health perspectives.

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Section: Anti-ro/ssa-associated Long-qt Syndromementioning

confidence: 99%

Anti-Ro/SSA Antibodies and the Autoimmune Long-QT Syndrome

et al. 2021

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“…Variables of study; Table S4. Anti-Ro60, anti-Ro52 and anti-La/SSB antibodies: positivity, titer strength, and time since first positivity [ 3 , 15 , 17 , 18 , 19 , 21 , 25 , 26 , 27 , 35 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ].…”

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confidence: 99%

Should Physicians Be Aware of Rhythm Disturbances in Adults with Systemic Autoimmune Diseases and Anti-Ro52 Antibodies? A Cross-Sectional Study

Gamazo-Herrero,

Medina-Luezas,

Cusacovich

et al. 2024

JCM

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Objectives: The association between anti-Ro/SSA antibodies and the appearance of cardiac rhythm disorders in adults is discussed. We aim to study this relationship, together with active treatments and comorbidities, and its impact on daily clinical practice in adults with systemic autoimmune diseases (SADs). Methods: This cross-sectional single-center study was conducted in a tertiary hospital between January 2021 and March 2022. A sample of adult patients followed up in the SAD Unit with a diagnosis of a SAD and previously tested for anti-Ro/SSA and anti-La/SSB were recruited. All of them underwent a 12-lead electrocardiogram. Results: 167 patients were included. 90 (53.9%) were positive for anti-Ro60, 101 (60.5%) for anti-Ro52, and 45 (26.9%) for anti-La/SSB; 52 (31.3%) were triple-negative. 84% were women, and the mean age was 59 years (standard deviation 12.8). The most common SAD was primary Sjögren’s syndrome (34.8%), followed by systemic lupus erythematosus (24.6%) and rheumatoid arthritis (22.8%). A statistically significant relationship was found between anti-Ro52 positivity and cardiac rhythm disorders (relative risk = 2.007 [1.197–3.366]), specifically QTc prolongation (relative risk = 4.248 [1.553–11.615]). Multivariate regressions showed a significant association, with diabetes mellitus being the most related comorbidity. The association between anti-Ro52 antibodies and atrioventricular conduction disorders was not significant. Conclusions: The presence of anti-Ro52 antibodies in adult patients with SADs is associated with an increased risk of QTc prolongation. Electrocardiographic screening of patients with SAD, anti-Ro52 antibodies, and other risk factors, like diabetes mellitus or QT-prolonging drugs, seems advisable. Those with baseline electrocardiogram abnormalities or additional risk factors should undergo electrocardiographic monitoring.

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