Systemic sclerosis & Raynaud's
Sudden cardiac death, arrhythmias and abnormal electrocardiography in systemic sclerosis: A systematic review and meta-analysis
Authors' conclusion
The incidence of SCD in SSc is estimated to be 1.0-3.3% annually, at least 10-fold higher than general population estimates.
Study context
- Population
- Participants with SSc in English-language studies reporting incidence/frequency of sudden cardiac death (SCD), arrhythmia and electrocardiography (ECG) abnormalities; MEDLINE/EMBASE to January 2023
- Participants
- 13,609 participants79 studies
- Comparison
- SSc cohorts with known/suspected SSc-associated heart involvement (SHI), without SHI, and unselected; vs healthy controls where reported
- Outcome
- Frequency of sudden cardiac death (SCD), arrhythmia and conduction defects in SSc
Methodological detailsMethodology and outcomes were heterogeneous
- Methodology and outcomes were heterogeneous
Pooled result
As reported in the abstract
Annual incidence of SCD
| Group | Value | Studies | Follow-up |
|---|---|---|---|
| SHI | 3.3% annually | 4 | 301PY |
SHI
Value3.3% annually
Studies4
Follow-up301PY
- Estimated SCD incidence in cohorts without SHI (n = 1 study, 67.5PY)
- ≈2.9% annually
- Estimated SCD incidence in general SSc cohorts unselected for cardiac disease (n = 4 studies, 1646PY)
- 2.0% annually
Further pooled results
| Outcome | Estimate |
|---|---|
| Arrhythmias without SHI vs healthy controlsWithout SHI vs Healthy controls · NSVT; n = 2 | times more frequently 13.3 (95% CI 2–102) |
| Arrhythmias without SHI vs healthy controlsWithout SHI vs Healthy controls · paroxysmal supraventricular tachycardia; n = 4 | times more frequently 7 (95% CI 3–15) |
| Unselected SSc cohorts: frequent PVCs and abnormal ECGUnselected SSc vs Healthy controls · frequent PVCs; n = 2 | times more likely 10.5 (95% CI 2–59) |
| Unselected SSc cohorts: frequent PVCs and abnormal ECGUnselected SSc vs Healthy controls · abnormal ECG; n = 2 | times more likely 2.5 (95% CI 1–4) |
Ambulatory ECG abnormalities in SHI cohorts
- Non-sustained ventricular tachycardia (NSVT) (n = 4, 95%CI3.2-39.3%)
- 18%
- Frequent premature ventricular complexes (PVCs) (n = 1, 95%CI34.8-93.3%)
- 70%
- Atrial fibrillation (AF) (n = 1, 95%CI4.2-13.6%)
- 8%
Other ambulatory ECG abnormalities in cohorts without SHI
- NSVT (n = 7, 95%CI6-14%)
- 9%
- >1000 PVCs/24 h (n = 2, 95%CI1-13%)
- 6%
- AF (n = 5, 0-21%)
- 7%
Original publication
Sudden cardiac death, arrhythmias and abnormal electrocardiography in systemic sclerosis: A systematic review and meta-analysis. Semin Arthritis Rheum. Published 19 June 2023. doi:10.
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