TY - JOUR
T1 - Association of anti-Ro seropositivity with cardiac rhythm and conduction disturbances
AU - Akuka, Aviram
AU - Ben-Shabat, Niv
AU - Watad, Abdulla
AU - Tsur, Avishai M.
AU - Ehrenberg, Scott
AU - McGonagle, Dennis
AU - Comaneshter, Doron
AU - Beinart, Roy
AU - Cohen, Arnon D.
AU - Amital, Howard
N1 - Publisher Copyright:
© The Author(s) 2022. Published by Oxford University Press on behalf of European Society of Cardiology. All rights reserved.
PY - 2022/12/14
Y1 - 2022/12/14
N2 - Aims Anti-Ro/La autoantibodies are especially prevalent in autoimmune diseases but are also relatively frequent in healthy adults. Their arrhythmogenic effect on the immature cardiac conductive system is well established, with substantial evidence demonstrating an increased risk for congenital atrioventricular block in neonates of seropositive mothers. Despite their wide distribution and their arrhythmogenic potential effect, there are no large population studies conducted in seropositive adults. Thus, this is the first large population-based study to examine the association of anti-Ro/La seropositivity with cardiac rhythm and conduction disturbances. Methods This cross-sectional designed study involved the electronic health records of the largest health maintenance organization in and results Israel. All subjects that were tested positive for anti-Ro/anti-La antibodies between the years 2002 and 2019 were included and were matched by age, gender, and place of residence, with controls. Rates of different cardiac rhythm and conduction disturbances were compared between groups. Sensitivity analyses were performed using propensity score matching. The study population included 17 231 anti-Ro/La seropositive subjects and 84 368 controls. Anti-Ro seropositive patients had higher rates of conduction disturbances (3.0 vs. 1.7%, P < 0.001) and rhythm disturbances (10.5 vs. 7.0%, P < 0.001). Patients who tested positive for anti-La alone did not demonstrate a significant association with arrhythmias. Multivariate logistic regression analysis, controlling for possible confounders, showed an increased risk for cardiac conduction disturbances [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.25–1.66, P < 0.001], as well as for cardiac rhythm disturbances (OR 1.21, 95% CI 1.11–1.31, P < 0.001) among anti-Ro seropositive patients. However, the association with rhythm disturbances was more robust in certain subgroup analyses. Conclusions Anti-Ro seropositivity is positively associated with adult cardiac conduction disturbances and, to a lesser extent, cardiac rhythm disturbances, regardless of the presence of concurrent autoimmune disease.
AB - Aims Anti-Ro/La autoantibodies are especially prevalent in autoimmune diseases but are also relatively frequent in healthy adults. Their arrhythmogenic effect on the immature cardiac conductive system is well established, with substantial evidence demonstrating an increased risk for congenital atrioventricular block in neonates of seropositive mothers. Despite their wide distribution and their arrhythmogenic potential effect, there are no large population studies conducted in seropositive adults. Thus, this is the first large population-based study to examine the association of anti-Ro/La seropositivity with cardiac rhythm and conduction disturbances. Methods This cross-sectional designed study involved the electronic health records of the largest health maintenance organization in and results Israel. All subjects that were tested positive for anti-Ro/anti-La antibodies between the years 2002 and 2019 were included and were matched by age, gender, and place of residence, with controls. Rates of different cardiac rhythm and conduction disturbances were compared between groups. Sensitivity analyses were performed using propensity score matching. The study population included 17 231 anti-Ro/La seropositive subjects and 84 368 controls. Anti-Ro seropositive patients had higher rates of conduction disturbances (3.0 vs. 1.7%, P < 0.001) and rhythm disturbances (10.5 vs. 7.0%, P < 0.001). Patients who tested positive for anti-La alone did not demonstrate a significant association with arrhythmias. Multivariate logistic regression analysis, controlling for possible confounders, showed an increased risk for cardiac conduction disturbances [odds ratio (OR) 1.44, 95% confidence interval (CI) 1.25–1.66, P < 0.001], as well as for cardiac rhythm disturbances (OR 1.21, 95% CI 1.11–1.31, P < 0.001) among anti-Ro seropositive patients. However, the association with rhythm disturbances was more robust in certain subgroup analyses. Conclusions Anti-Ro seropositivity is positively associated with adult cardiac conduction disturbances and, to a lesser extent, cardiac rhythm disturbances, regardless of the presence of concurrent autoimmune disease.
KW - Anti-La
KW - Anti-Ro
KW - Atrioventricular block
KW - Cardiac arrhythmia
KW - Conduction disturbances
UR - http://www.scopus.com/inward/record.url?scp=85144584697&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehac516
DO - 10.1093/eurheartj/ehac516
M3 - Article
C2 - 36148481
AN - SCOPUS:85144584697
SN - 0195-668X
VL - 43
SP - 4912
EP - 4919
JO - European Heart Journal
JF - European Heart Journal
IS - 47
ER -