Systemic lupus erythematosus increases risk of incident atrial fibrillation: A systematic review and meta-analysis

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Yanlin Chen1, Lu Fu1, Sijia Pu1

  • 1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

International Journal of Rheumatic Diseases
|July 30, 2022
PubMed

Insights

Systemic lupus erythematosus (SLE) is linked to a higher risk of developing atrial fibrillation (AF). This meta-analysis confirms SLE as a risk factor for AF, with findings varying by geographic location.

Area of Science:

  • Cardiology
  • Rheumatology
  • Epidemiology

Background:

  • Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by chronic inflammation.
  • Inflammation associated with SLE may increase the risk of cardiovascular complications, including atrial fibrillation (AF).
  • The prevalence and specific risk associated with AF in SLE patients require further quantification.

Purpose of the Study:

  • To systematically review and meta-analyze existing clinical data.
  • To determine the correlation between SLE and the risk of developing AF.
  • To explore potential variations in this risk based on geographical distribution.

Main Methods:

  • A systematic literature search was conducted across major electronic databases (PubMed, Scopus, ScienceDirect, Cochrane Library, Web of Science).
  • Meta-analysis was performed using Review Manager 5.4, including subgroup analyses by geographical distribution.
  • Pooled risk ratios (RR) and 95% confidence intervals (CI) were calculated using random-effect or fixed-effect models.

Main Results:

  • Six cohort studies with 311,844 participants (78,134 SLE cases) indicated an increased risk of AF in SLE patients (RR = 1.85, 95% CI: 1.23-2.79).
  • Subgroup analysis of European/American populations showed a significant increase in AF risk (RR = 1.79, 95% CI: 1.61-1.98).
  • Analysis of Korean studies showed no significant correlation (RR = 1.81, 95% CI: 0.39-8.43), indicating potential geographic variability.

Conclusions:

  • Systemic lupus erythematosus (SLE) is suggested as a potential risk factor for atrial fibrillation (AF) development.
  • The observed association between SLE and AF risk may be influenced by geographic factors.
  • Further research may be warranted to elucidate the mechanisms and regional differences in AF risk among SLE patients.
Abstract

Keywords:
atrial fibrillationepidemiologyheterogeneitymeta-analysissystemic lupus erythematosus

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