BACKGROUND: Epidemiological studies have shown a strong association between systemic inflammatory diseases, particularly allergic diseases, and cardiovascular diseases. However, the relationship between atopic dermatitis (AD) and ischemic stroke remains unclear. METHOD: The study identified 20,323 AD patients and 20,323 comorbidity-matched subjects between 2005 and 2008. The two cohorts were followed until 31 December 2009. Ischemic stroke and other cardiovascular events were determined. RESULTS: During the follow-up period, 301 (1.48%) patients in the AD cohort and 228 (1.12%) matched subjects experienced ischemic stroke. After multivariate adjustment, patients with AD had a 1.33-fold (95% confidence interval (CI), 1.12-1.59; P = 0.001) increased incidence of ischemic stroke. Adjusted hazard ratios for the risk of ischemic stroke in patients with mild, moderate, and severe AD were 1.20 (95% CI, 1.00-1.45; P = 0.052), 1.64 (95% CI, 1.23-2.19; P = 0.001), and 1.71 (95% CI, 1.15-2.56; P = 0.008), respectively. The log-rank test showed a higher cumulative incidence of ischemic stroke in the severe AD group than in the moderate and mild AD groups during the follow-up period (P < 0.001). CONCLUSIONS: AD may be an independent risk factor for ischemic stroke, and risk of ischemic stroke increases with AD severity.
BACKGROUND: Epidemiological studies have shown a strong association between systemic inflammatory diseases, particularly allergic diseases, and cardiovascular diseases. However, the relationship between atopic dermatitis (AD) and ischemic stroke remains unclear. METHOD: The study identified 20,323 ADpatients and 20,323 comorbidity-matched subjects between 2005 and 2008. The two cohorts were followed until 31 December 2009. Ischemic stroke and other cardiovascular events were determined. RESULTS: During the follow-up period, 301 (1.48%) patients in the AD cohort and 228 (1.12%) matched subjects experienced ischemic stroke. After multivariate adjustment, patients with AD had a 1.33-fold (95% confidence interval (CI), 1.12-1.59; P = 0.001) increased incidence of ischemic stroke. Adjusted hazard ratios for the risk of ischemic stroke in patients with mild, moderate, and severe AD were 1.20 (95% CI, 1.00-1.45; P = 0.052), 1.64 (95% CI, 1.23-2.19; P = 0.001), and 1.71 (95% CI, 1.15-2.56; P = 0.008), respectively. The log-rank test showed a higher cumulative incidence of ischemic stroke in the severe AD group than in the moderate and mild AD groups during the follow-up period (P < 0.001). CONCLUSIONS:AD may be an independent risk factor for ischemic stroke, and risk of ischemic stroke increases with AD severity.
Authors: Benjamin Ungar; Ana B Pavel; Philip M Robson; Audrey Kaufman; Alison Pruzan; Patrick Brunner; Shivani Kaushik; James G Krueger; Mark G Lebwohl; Venkatesh Mani; Zahi A Fayad; Emma Guttman-Yassky Journal: J Allergy Clin Immunol Pract Date: 2020-07-25