Table 1.
Ref. | Design | RA patients | Controls | Impact of RA and QT dispersion (QTd) and QTc | Association between QT parameter, and disease activity/duration (1), arrhythmia (2), autonomic dysfunction (3), mortality (4) |
[54] | Cross-sectional | 42 | 42 | ↑ QTd variables (QTd, QTcD, JTD, JTcD) vs controls No difference in QTc vs controls | (1) ESR, CRP (2) Complex premature ventricular beats |
[55] | Cross-sectional | 40 | 48 | ↑ QTd variables (QTd, QTcD) vs controls | (1) Disease duration |
[56] | Cross-sectional | 40 | 40 | ↑ QTd vs controls | (1) Extra-articular manifestations, erosive disease |
[57] | Cross-sectional | 58 | 29 | ↑ QT vs controls | (1) Secondary Sjörgen’s syndrome |
[58] | Cross-sectional | 100 | 100 | ↑ QTd vs controls | (1) Disease duration, DAS28, ESR, number of joints involved |
[59] | Cross-sectional | 25 | 21 controls 76 with spondylarthopathy | ↑ QTc vs controls and those with spondyloarthopathies Infliximab therapy duration inversely correlated to QTc (P < 0.01) | (1) CRP (3) ↑ QTC associated with ↑ HR, autonomic dysfunction, particularly sympathetic dysfunction as assessed by spectral parameters of heart rate variability |
[60] | Prospective cohort | 357 | _ | ↑ QTc 10% males (QTc ≥ 450 ms) and 5.6% of females (QTc ≥ 460 ms) | (1) CRP (4) Doubled risk of all-cause mortality per 50 ms increase in QTc, (lost after adjustment for CRP) HR = 2.17 (95%CI: 1.21-3.90) |
[61] | Retrospective cohort | 417 | 422 | ↑ % of RA patients with QTc prolongation (> 450 ms males, > 460 ms females) vs controls 20 yr after disease onset (48% vs 38%, P = 0.004) | (1) ESR (4) Any cause QTc prolongation was associated with ↑ all-cause mortality HR = 2.99 (95%CI: 1.93-4.65) |
[62] | Prospective cohort | 17 | _ | ↑ QTc (> 440 ms) in 76% of patients Toclizumab associated with 47% ↓ in No. patients with QTc prolongation (P = 0.006) | (1) CRP and TNF-α |
[70] | Cross-sectional | 117 | - | (1) CRP, TNF-α, IL-1β and IL 10 ( QTc BAZ) (1) IL-1β and IL 10, trend towards TNF-α (QTc FHS) |
RA: Rheumatoid arthritis; QTd: QT interval dispersion; QTc: Heart-rate corrected QT interval; QTcD: Heart-rate corrected QT interval dispersion; JTD: JT interval dispersion; JTcD: Heart-rate corrected JT interval dispersion; DAS28: Disease activity score in 28 joints; ESR: Erythrocyte sedimentation rate; CRP: C-reactive protein; ms: Milliseconds; QTc BAZ: QTc calculated using Bazett formula; QTc FHS: QTc calculated using Framingham formula.