Background:Ankylosing spondylitis (AS) has been associated with different comorbidities, particularly some of cardiac origin. Recently, some studies have been published that suggest that certain arrhythmias may be more frequent in AS than in the general population.Objectives:To estimate the prevalence of arrhythmias in patients diagnosed of AS in our environment and to compare it with that of the general population.Methods:Descriptive cross-sectional study in patients diagnosed with AS by New York criteria, seen in our Department from 1st January 2018 to 30th March 2019, with age ≥ 18 years. A baseline 12-lead ECG was performed unless patients already had an ECG or a 24-hour Holter in the previous year. Likewise, demographic and disease-related variables were collected, such as: sex, age, body mass index (BMI), HLA-B27, year of diagnosis, pattern of involvement, comorbidities, ESR and CRP, BASFI and BASDAI (scales of 0 to 100), questionnaire about physical exercise, tobacco habits and treatments received. Descriptive statistical analysis was performed by calculating means with their standard deviation (SD) and percentages with their confidence intervals (CI). Prevalence of arrhythmias obtained in AS was compared with studies that determined the prevalence in the general population (statistical tool: SPSS).Results:117 patients with AS (62.4% men), mean age 54.8 years (± SD: 15.7), disease progression of 14.7 ± 9.6 years were included. HLA B27 was positive in 75.4%. Mean values of ESR and CRP were 14.4 mm/h and 0.6 mg/dl, respectively, and the average of the BASFI and BASDAI scores were 26/100 and 30/100, respectively. The prevalence of heart rhythm disorders was 19.7% (95% CI 12.3-27.0), which was significantly associated with advanced age, arterial hypertension and body mass index (BMI). No association was found with other activity or functional disease parameters (CRP, BASDAI, BASFI). The rhythm disorders found were: 9.4% (95% CI: 4.0-14.8) of the patients presented supraventricular tachyarrhythmias; 7.7% (95% CI: 2.7-12.6) had atrioventricular blocks and 6.8% (95% CI: 2.2-11.5) intraventricular conduction disorders. Although no differences were found regarding the prevalence described in the general population, an associative trend was observed, although it did not reach statistical significance probably due to the small sample size recruited.Conclusion:There seems to be an increased tendency of heart rhythm disorders in patients with AS compared to the general population, which may have clinical and therapeutic implications. However, studies with larger sample size are needed to corroborate these results. In addition, there was a relationship between the presence of arrhythmias and certain pro-inflammatory situations (older age and BMI, although not CRP), which supports the hypothesis that some underlying inflammation status in these patients could partly justify an increased arrhythmogenesis.Disclosure of Interests:Carlos Rodríguez-López: None declared, Esther Vicente Speakers bureau: BMS, Roche., Eva Tomero Muriel: None declared, Juan Pedro López-Bote: None declared, Lorena Vega: None declared, Isidoro González-Álvaro Grant/research support from: Roche Laboratories, Consultant of: Lilly, Sanofi, Paid instructor for: Lilly, Speakers bureau: Abbvie, MSD, Roche, Lilly, Alicia Humbría: None declared, Jesús Jiménez Borreguero: None declared, Rosario Garcia de Vicuna Grant/research support from: BMS, Lilly, MSD, Novartis, Roche, Consultant of: Abbvie, Biogen, BMS, Celltrion, Gebro, Lilly, Mylan, Pfizer, Sandoz, Sanofi, Paid instructor for: Lilly, Speakers bureau: BMS, Lilly, Pfizer, Sandoz, Sanofi, Fernando Alfonso Manterola: None declared, Santos Castañeda: None declared
Effect of HLA-B27 status and body mass index on the clinical response to infliximab in ankylosing spondylitis patients
