The Incidence Rate and Risk Factors of Arrhythmias in Patients with Psoriatic Arthritis
Bibliographic record
Abstract
Objectives To estimate the cumulative incidence rates (CIRs) and risk factors for cardiac tachy- and bradyarrhythmias in patients with psoriatic arthritis (PsA). Methods We performed an analyses of the University of Toronto PsA prospective cohort from its inception in 1978 to April 2024. Patients were assessed every 6 to 12 months following a standard protocol where demographic, clinical, comorbidity and medication data were collected. Arrhythmia events were identified via record linkage with provincial hospitalization databases and review of medical records by physicians. Arrhythmia endpoints were classified as atrial (defined as atrial fibrillation, flutter or supraventricular tachycardia), ventricular (defined as ventricular tachycardia, fibrillation or placement of cardiac resynchronization therapy with a defibrillator) and bradyarrhythmias (defined as second- or third-degree atrioventricular block or placement of pacemaker). Cox proportional hazard regression models were used to evaluate the association between PsA measures of disease activity (measured as time-varying (TV) or cumulative average (CA)) and each arrhythmia endpoint separately. Each model was hierarchically adjusted for potential confounders as follows: Model 1: adjusted for age and sex, model 2: also adjusted for cardiovascular risk factors, and model 3: added information on PsA therapies. Results Of 1670 PsA patients (mean age 46.35 years, 54.2% male) included in this analysis, a total of 80 atrial, 17 brady and 11 ventricular arrhythmias were identified. By 70 years of age, the overall CIRs were 0.08 (95% confidence interval (CI) 0.06-0.10), 0.01 (95% CI 0.00-0.01) and 0 (95% CI 0.00-0.01) for atrial, ventricular and bradyarrhythmias, respectively. In the fully adjusted multivariable model (Model 3, Table 1), higher Disease Activity Index for PsA (DAPSA) was associated with higher risk of atrial arrhythmia. The following variables were significantly associated with higher risk of atrial arrhythmia: higher DAPSA score, hazard ratio (HR) 1.15, 95% CI (1.03-1.29) was associated with a 10-unit higher value for CA covariate; and higher 3-visual analog scale (3-VAS) with HR of 1.18, 95% CI (1.04-1.33) for TV and 1.22, 95% CI (1.04-1.44) for CA covariates. On the other hand, remission/low vs high disease activity measured by DAPSA with HR of 0.49, 95% CI (0.26-0.92) for TV and 0.46, 95% CI (0.23-0.91) for CA covariates were significantly associated with lower risk of atrial arrhythmia. Table 1: Risk of developing atrial arrhythmia in patients with PsA using Cox proportional hazards models (N=1670, 80 events). Conclusion Higher burden of disease activity in PsA is associated with higher atrial arrhythmia risk. These findings reinforce the importance of controlling inflammation in PsA to optimize cardiac health.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".