Prevalence and Risk for Bundle Branch Block, Atrioventricular Block and Pacemaker Implantation in Spondyloarthritis. A Systematic Review of the Literature
Park, Hye S. (Institut d'Investigació Biomèdica Sant Pau)
Laiz, Ana (Universitat Autònoma de Barcelona. Departament de Medicina)
Díaz del Campo, Petra (Sociedad Española de Reumatología (SER))
Martín Martínez, María A. (Institut d'Investigació Biomèdica Sant Pau)
Guerra-Rodriguez, M. (Sociedad Española de Reumatología (SER))
Alonso-Martin, Concepción (Institut d'Investigació Biomèdica Sant Pau)
Sanchez-Vega, Jesus (Hospital Universitari de Bellvitge)
Corominas, Hèctor (Universitat Autònoma de Barcelona. Departament de Medicina)

Date:	2022
Abstract:	To evaluate the evidence regarding the prevalence and risk of bundle branch block (BBB), atrioventricular block (AVB) and pacemaker implantation (PMI) in patients with spondyloarthritis compared to a control group without spondyloarthritis. A systematic review of the literature was performed using Pubmed (Medline), EMBASE (Elsevier) and Cochrane Library (Wiley) databases until December 2021. The prevalence and risk for AVB, BBB and PMI were analyzed. Cohort, case control and cross-sectional studies in patients ≥18 years meeting the classification criteria for spondyloarthritis were included. The Odds ratio (OR), risk ratio (RR), or Hazard ratio (HR) and prevalence difference were considered as outcomes. Data was synthesized in a previously defined extraction form which included a risk of bias assessment using the Newcastle-Ottawa Scale. In total, eight out of 374 studies were included. None of the studies provided results regarding the risk of low grade AVB and BBB in SpA patients. Only indirect results comparing prevalences from low to medium quality studies were found. According to population based registries, the sex and age adjusted HR of AVB was 2. 3 (95% CI 1. 6-3. 3) in ankylosing spondylitis, 2. 9 (95% CI 1. 8-4. 7) in undifferentiated spondyloarthritis and 1. 5 (95% CI 1. 1 a 1. 9) in psoriatic arthritis. The absolute risk for AVB was 0. 4% (moderate to high; 95% CI 0. 34%-0. 69%) for AS, 0. 33% (moderate to high; 95% CI 0. 21%-0. 53%) for uSpA and 0. 34% (moderate to high; 95% CI 0. 26%-0. 45%) for PsA. The RR for PMI in AS patients was 1. 3 (95% CI 1. 16-1. 46) for groups aged between 65 and 69 years, 1. 33 (95% CI 1. 22-1. 44) for 70-75 years, 1. 24 (95% CI 1. 55-1. 33) for 75-79 years and 1. 11 (95% CI 1. 06-1. 17) for groups older than 80 years. The absolute risk for PMI in AS patients was 0. 7% (moderate to high risk; 95% CI 0. 6-0. 8%) for groups aged between 65-69, 1. 44% (high risk; 95% CI 1. 33-1. 6%) for 70-75 years, 2. 09% (high risk; 95% CI 2. 0-2. 2%) for 75-79 years and 4. 15% (high risk; 95% CI 4. 0-4. 3%) for groups older than 80 years Very few cases of low grade AVB and BBB were observed in observational studies. No study evaluated association measures for low grade AVB and BBB but the differences of prevalence were similar in SpA and control groups even though studies lacked the power to detect statistical differences. According to population based registries there was an approximately two fold-increased risk of high grade AVB in SpA patients. RR for PMI was higher in younger age groups.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article de revisió ; recerca ; Versió publicada
Subject:	Spondylarthritis ; Spondyloarthritis ; Cardiac conduction system disease ; Pacemaker ; Epidemiology ; Systematic review
Published in:	Frontiers in Medicine, Vol. 9 (march 2022) , ISSN 2296-858X

DOI: 10.3389/fmed.2022.851483
PMID: 35402464

8 p, 434.8 KB

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