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Possible relationship between hydroxychloroquine and electrocardiographic and echocardiographic abnormalities in patients with inflammatory rheumatic diseases--a monocentric study.
Pinheiro, Filipe Oliveira; Martins Carvalho, Miguel; Madureira, Pedro; Seabra Rato, Maria; Macedo, Filipe; Costa, Lúcia.
  • Pinheiro FO; Rheumatology Department, 285211Centro Hospitalar Universitário de São João, Porto, Portugal.
  • Martins Carvalho M; Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal.
  • Madureira P; Medicine Department, Faculty of Medicine, University of Porto, Porto, Portugal.
  • Seabra Rato M; Cardiology Department, 285211Centro Hospitalar Universitário de São João, Porto, Portugal.
  • Macedo F; Rheumatology Department, 285211Centro Hospitalar Universitário de São João, Porto, Portugal.
  • Costa L; Rheumatology Department, 285211Centro Hospitalar Universitário de São João, Porto, Portugal.
Lupus ; 32(3): 388-393, 2023 Mar.
Article in English | MEDLINE | ID: covidwho-2195006
ABSTRACT

OBJECTIVE:

Hydroxychloroquine (HCQ) is used in the treatment of inflammatory rheumatic diseases and is considered a safe drug. The role of HCQ in the COVID-19 pandemic highlighted some deleterious cardiac effects of HCQ. We aim to evaluate the prevalence and development of cardiac-adverse events in HCQ-treated patients with inflammatory rheumatic diseases.

METHODS:

We performed a cross-sectional study where patients aged ≥18 years with a diagnosis of inflammatory rheumatic disease currently exposed or not to hydroxychloroquine underwent electrocardiogram (ECG) and echocardiogram. Comparisons between groups were evaluated using chi-square, t test, and Mann-Whitney U test. Logistic regression was performed to determine predictors of changes in ECG and echocardiography.

RESULTS:

Eighty patients were included, 75 (93.8%) female, aged 52 ± 13 years. ECG changes were seen in higher proportion in patients with hypertension (40.6% vs 12.5%, p = .004) and higher median potassium levels-4.5 (4.1-4.8) versus 4.2 (4.0-4.4), p = .023. Echocardiography changes were seen in older patients (59 ± 11 vs 50 ± 13 years, p = .003) and in patients with higher cumulative dose-1752 (785-2190) versus 438 (328-1022) g, p = 0.008 - and time of exposure to HCQ - 12 (6-15) versus 4 (2-9) years, p = 0.028. HCQ cumulative dose (OR 1.001, CI95% 1.000-1.002, p = .033) and exposure time (OR 1.136, CI95% 1.000-1.289, p = .049) were predictors of echocardiography changes, but when adjusted for age, neither HCQ cumulative dose nor exposure time were predictors of echocardiography changes.

CONCLUSION:

No association was found between changes in ECG and echocardiogram in patients under HCQ, which remains a safe drug in patients with inflammatory rheumatic diseases.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Antirheumatic Agents / COVID-19 / Lupus Erythematosus, Systemic Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: English Journal: Lupus Journal subject: Rheumatology Year: 2023 Document Type: Article Affiliation country: 09612033221149875

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Rheumatic Diseases / Antirheumatic Agents / COVID-19 / Lupus Erythematosus, Systemic Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Adolescent / Adult / Aged / Female / Humans / Male Language: English Journal: Lupus Journal subject: Rheumatology Year: 2023 Document Type: Article Affiliation country: 09612033221149875