Background Cardiac involvement is in more than half of the patients with systemic lupus erythematosus (SLE). However, large scale studies on the prevalence of atrial fibrillation (AF) in this disease do not exist. We aimed to investigate the incidence and clinical significance of AF in SLE.

Methods Patients with SLE (n=21,143; mean age, 41.8±13.13 years; female, 90.38%) without previous AF were selected from the Korean National Health Insurance Service National Sample Cohort database between 2008 and 2014. Age-and sex-matched controls (n=105,715) were randomly sampled in a 5:1 ratio from the population of individuals without SLE from same database. Both cohorts were followed-up for incidental AF and death until 2015.

Results AF was newly detected in 481 (2.27%) in SLE and 619 (0.59%) controls (incidence: 3.692 and 0.941 per 1000 person-years, respectively). After multivariate adjustment, SLE were found to be at a higher risk of developing AF compared to controls (hazard ratio (HR), 2.84; 95% confidence interval (CI), 2.50–3.23). On subgroup analysis, younger (age <40) patients showed higher incidence of AF. SLE with incidental AF had a higher mortality rate compared to patients without SLE with AF (HR, 2.35; 95% CI 1.73–3.20) and SLE without AF (HR, 3.53; 95% CI 2.84–4.39) after adjustment.

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Abstract 42 Figure 1

Kaplan-Meyer curves showing incidence of atrial fibrillation in SLE and non-SLE patients.

Conclusions SLE was an independent risk factor for AF development, especially in younger patients without previous AF, stressing the importance of cardiac assessment in this population. AF development in patients with SLE was associated with increased mortality.

Funding Source(s): Kaplan-Meyer curves of atrial fibrillation in SLE and non-SLE patients.