BACKGROUND: Systemic lupus erythematosus (SLE) has been reported to be associated with an increased risk of cardiovascular disease. However, most studies have been criticized for either a small sample size or the lack of a prospective control. Our study investigated the relationship of SLE and the subsequent development of ischemic stroke using a nationwide, population-based database in an Asian population. METHODS: From 2000 to 2007, we identified a study cohort consisting of a total of 11,637 newly diagnosed SLE patients using the National Health Insurance Research Database in Taiwan. A control cohort of 58,185 subjects without SLE, matched for age, gender, and comorbidities were selected for comparison to observe the occurrence of ischemic stroke in these two groups. RESULTS: During a follow-up period of up to 7 years, ischemic stroke developed in 258 (2.22%) of the patients with SLE and in 873 (1.5%) of patients in the comparison cohort. Kaplan-Meier analysis also revealed a tendency of SLE patients toward ischemic stroke development (log rank test, p = 0.001). After Cox model adjustment for patients' demographic characteristics and selected comorbidities, patients with SLE were found to have a 1.67-fold (95% CI, 1.45 to 1.91) higher risk of developing ischemic stroke. CONCLUSION: Patients with SLE have an increased risk of stroke.
BACKGROUND:Systemic lupus erythematosus (SLE) has been reported to be associated with an increased risk of cardiovascular disease. However, most studies have been criticized for either a small sample size or the lack of a prospective control. Our study investigated the relationship of SLE and the subsequent development of ischemic stroke using a nationwide, population-based database in an Asian population. METHODS: From 2000 to 2007, we identified a study cohort consisting of a total of 11,637 newly diagnosed SLEpatients using the National Health Insurance Research Database in Taiwan. A control cohort of 58,185 subjects without SLE, matched for age, gender, and comorbidities were selected for comparison to observe the occurrence of ischemic stroke in these two groups. RESULTS: During a follow-up period of up to 7 years, ischemic stroke developed in 258 (2.22%) of the patients with SLE and in 873 (1.5%) of patients in the comparison cohort. Kaplan-Meier analysis also revealed a tendency of SLEpatients toward ischemic stroke development (log rank test, p = 0.001). After Cox model adjustment for patients' demographic characteristics and selected comorbidities, patients with SLE were found to have a 1.67-fold (95% CI, 1.45 to 1.91) higher risk of developing ischemic stroke. CONCLUSION:Patients with SLE have an increased risk of stroke.
Authors: Carlos A Roldan; Oleksandr Schevchuck; Kirsten Tolstrup; Paola C Roldan; Leonardo Macias; Clifford R Qualls; Ernest R Greene; Reyaad Hayek; Gerald A Charlton; Wilmer L Sibbitt Journal: Cerebrovasc Dis Date: 2015-06-02 Impact factor: 2.762
Authors: Zoe Arvanitakis; Robin L Brey; Jacob H Rand; Julie A Schneider; Ana W Capuano; Lei Yu; Sue E Leurgans; David A Bennett; Steven R Levine Journal: Circulation Date: 2014-10-09 Impact factor: 29.690
Authors: Sarah K Chen; Medha Barbhaiya; Daniel H Solomon; Hongshu Guan; Kazuki Yoshida; Candace H Feldman; Brendan M Everett; Karen H Costenbader Journal: J Rheumatol Date: 2019-11-01 Impact factor: 4.666
Authors: Vinh A Nguyen; Leeanne M Carey; Loretta Giummarra; Pierre Faou; Ira Cooke; David W Howells; Tamara Tse; S Lance Macaulay; Henry Ma; Stephen M Davis; Geoffrey A Donnan; Sheila G Crewther Journal: Front Neurol Date: 2016-06-14 Impact factor: 4.003