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  • Mofors, JKarolinska Institutet (author)

Comorbidity and long-term outcome in patients with congenital heart block and their siblings exposed to Ro/SSA autoantibodies in utero

  • Article/chapterEnglish2019

Publisher, publication year, extent ...

  • 2019-02-26
  • BMJ,2019

Numbers

  • LIBRIS-ID:oai:prod.swepub.kib.ki.se:141102028
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:141102028URI
  • https://doi.org/10.1136/annrheumdis-2018-214406DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Congenital heart block (CHB) may develop in fetuses of Ro/SSA autoantibody-positive women. Given the rarity of CHB, information on comorbidity and complications later in life is difficult to systematically collect for large groups of patients. We therefore used nation-wide healthcare registers to investigate comorbidity and outcomes in patients with CHB and their siblings.MethodsData from patients with CHB (n= 119) and their siblings (n= 128), all born to anti-Ro/SSA-positive mothers, and from matched healthy controls (n= 1,190) and their siblings (n= 1,071), were retrieved from the Swedish National Patient Register. Analyses were performed by Cox proportional hazard modelling.ResultsIndividuals with CHB had a significantly increased risk of cardiovascular comorbidity, with cardiomyopathy and/or heart failure observed in 20 (16.8%) patients versus 3 (0.3%) controls, yielding a HR of 70.0 (95% CI 20.8 to 235.4), and with a HR for cerebral infarction of 39.9 (95% CI 4.5 to 357.3). Patients with CHB also had a higher risk of infections. Pacemaker treatment was associated with a decreased risk of cerebral infarction but increased risks of cardiomyopathy/heart failure and infection. The risk of systemic connective tissue disorder was also increased in patients with CHB (HR 11.8, 95% CI 4.0 to 11.8), and both patients with CHB and their siblings had an increased risk to develop any of 15 common autoimmune conditions (HR 5.7, 95% CI 2.83 to 11.69 and 3.6, 95% CI 1.7 to 8.0, respectively).ConclusionsThe data indicate an increased risk of several cardiovascular, infectious and autoimmune diseases in patients with CHB, with the latter risk shared by their siblings.

Added entries (persons, corporate bodies, meetings, titles ...)

  • Eliasson, HKarolinska Institutet (author)
  • Ambrosi, AKarolinska Institutet (author)
  • Salomonsson, S (author)
  • Skog, AKarolinska Institutet (author)
  • Fored, MKarolinska Institutet (author)
  • Ekbom, AKarolinska Institutet (author)
  • Bergman, GKarolinska Institutet (author)
  • Sonesson, SEKarolinska Institutet (author)
  • Wahren-Herlenius, MKarolinska Institutet (author)
  • Karolinska Institutet (creator_code:org_t)

Related titles

  • In:Annals of the rheumatic diseases: BMJ78:5, s. 696-7031468-20600003-4967

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