Wei-Shih Huang1, Chun-Hung Tseng1, Pei-Chun Chen2, Chon-Haw Tsai1, Cheng-Li Lin3, Fung-Chang Sung4, Chia-Hung Kao5. 1. Department of Neurology, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. 2. Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan; Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan. 3. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan. 4. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan. Electronic address: fcsung@mail.cmu.edu.tw. 5. Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
Abstract
BACKGROUND AND AIMS: This cohort study assessed the association between inflammatory bowel disease (IBD) and the risk of future ischemic stroke. METHODS: The IBD cohort comprised adult patients (≥ 20years old) who had received either ambulatory or inpatient care between 1998 and 2011 and IBD-free controls were randomly selected from the general population and frequency matched according to age, sex, and index year (included 18,392 patients with IBD and 73,568 control patients). Both cohorts with ischemic stroke before the index date and the ischemic stroke cases diagnosed within one year after the index date were excluded. We observed the study patients until the incidence of ischemic stroke, death, withdrawal from the insurance program, or they were lost to follow-up, or the end of 2011. RESULTS: The risk of ischemic stroke was 1.12-fold (95% CI, 1.02-1.23) higher among the IBD cohort than among the non-IBD cohort. Compared to the subjects without IBD, the adjusted HR of ischemic stroke was 1.15 (95% CI 1.04-1.28) in the Crohn's disease (CD) patients and 1.01 (95% CI 0.84-1.21) in the ulcerative colitis (UC) group. The risk of developing ischemic stroke significantly increased with the increased frequency of IBD exacerbation and hospitalization. Furthermore, the adjusted HR among the CD patients increased in conjunction with the number of medical visits, from 1.07 to 6.36 and the adjusted HR among the UC patients also increased in conjunction with the number of medical visits, from 1.11 to 2.10. CONCLUSIONS: IBD exhibited an increased risk of developing ischemic stroke.
BACKGROUND AND AIMS: This cohort study assessed the association between inflammatory bowel disease (IBD) and the risk of future ischemic stroke. METHODS: The IBD cohort comprised adult patients (≥ 20years old) who had received either ambulatory or inpatient care between 1998 and 2011 and IBD-free controls were randomly selected from the general population and frequency matched according to age, sex, and index year (included 18,392 patients with IBD and 73,568 control patients). Both cohorts with ischemic stroke before the index date and the ischemic stroke cases diagnosed within one year after the index date were excluded. We observed the study patients until the incidence of ischemic stroke, death, withdrawal from the insurance program, or they were lost to follow-up, or the end of 2011. RESULTS: The risk of ischemic stroke was 1.12-fold (95% CI, 1.02-1.23) higher among the IBD cohort than among the non-IBD cohort. Compared to the subjects without IBD, the adjusted HR of ischemic stroke was 1.15 (95% CI 1.04-1.28) in the Crohn's disease (CD) patients and 1.01 (95% CI 0.84-1.21) in the ulcerative colitis (UC) group. The risk of developing ischemic stroke significantly increased with the increased frequency of IBD exacerbation and hospitalization. Furthermore, the adjusted HR among the CDpatients increased in conjunction with the number of medical visits, from 1.07 to 6.36 and the adjusted HR among the UC patients also increased in conjunction with the number of medical visits, from 1.11 to 2.10. CONCLUSIONS: IBD exhibited an increased risk of developing ischemic stroke.
Authors: Yanbo Tang; Kevin T Kline; Xiaoying S Zhong; Ying Xiao; Haifeng Lian; Jun Peng; Xiaowei Liu; Don W Powell; Guodu Tang; Qingjie Li Journal: PLoS One Date: 2021-09-20 Impact factor: 3.752