Cardiac Disturbances Increased in Spondyloarthritis Save

A prospective nationwide study from Sweden analyzed patients with AS (n=6448), PsA (n=16 063),  undifferentiated spondyloarthritis (uSpA; n=5190) and a general population controls (GP; n=2 66 435) between 2001–2009 and found a higher risk of aortic regurgitation and pacemaker use in SpA and higher risk of AV block, especially in men with AS or uSpA.

Atrial fibrillation (AF) wsa most common cardiac abnormality (5.5–7.4 events per 1000 person-years), followed by pacemaker implantation (PM) (1.0–2.0 events per 1000 person-years).

AS patients had significantly  increased hazard rations (HR) for AV block (HR 2.3), AF (1.2), PM (2.1) and aortic regurgitation (1.9). Higher  rates of all of these were seen in uSpA (HRs 2.9, 1.3, 1.9 and 2.0, respectively) and PsA (HRs 1.5, 1.5, 1.6 and 1.8, respectively) compared to controls.

The highest HRs were seen for AV block in male uSpA (HR 4.2) and AS (HR 2.5) compared with GP.

Pacemakers were higher in AS (HR 1.5) and AV blodk was also higher in uSpA (HR 1.5) when compared to PsA patients.

Conduction and valvular dysfunction is more common amongst SpA patients and should be screened for, especially in men.