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BMC Neurology

, 12:41

Cerebrovascular disease and stroke

Abstract

BackgroundCertain immune-mediated diseases IMDs have been associated with increased risk for cardiovascular disorders. The aim of the present study was to examine whether there is an association between 32 different IMDs and first hospitalization for ischemic or hemorrhagic stroke.

MethodsAll individuals in Sweden hospitalized with a main diagnosis of IMD without previous or coexisting stroke, between January 1, 1987 and December 31, 2008 n = 216,291, were followed for first hospitalization for ischemic or hemorrhagic stroke. The reference population was the total population of Sweden. Adjusted standardized incidence ratios SIRs for ischemic and hemorrhagic stroke were calculated.

ResultsTotally 20 and 15 of the 32 IMDs studied, respectively, were associated with an increased risk of ischemic and hemorrhagic stroke during the follow-up. The overall risks of ischemic and hemorrhagic stroke during the first year after hospitalization for IMD were 2.02 95% CI 1.90–2.14 and 2.65 95% CI 2.27–3.08, respectively. The overall risk of ischemic or hemorrhagic stroke decreased over time, to 1.50 95% CI 1.46–1.55 and 1.83 95% CI 1.69–1.98, respectively, after 1–5 years, and 1.29 95% CI 1.23–1.35 and 1.47 95% CI 1.31–1.65, respectively, after 10+ years. The risk of hemorrhagic stroke was ≥2 during the first year after hospitalization for seven IMDs: ankylosing spondylitis SIR = 8.11, immune thrombocytopenic purpura SIR = 8.60, polymyalgia rheumatica SIR = 2.06, psoriasis SIR = 2.88, rheumatoid arthritis SIR = 3.27, systemic lupus erythematosus SIR = 8.65, and Wegeners granulomatosis SIR = 5.83. The risk of ischemic stroke was ≥2 during the first year after hospitalization for twelve IMDs: Addison’s disease SIR = 2.71, Crohns disease SIR = 2.15, Graves disease SIR = 2.15, Hashimotos thyroiditis SIR = 2.99, immune thrombocytopenic purpura SIR = 2.35, multiple sclerosis SIR = 3.05, polymyositis-dermatomyositis SIR = 3.46, rheumatic fever SIR = 3.91, rheumatoid arthritis SIR = 2.08, Sjögren’s syndrome SIR = 2.57, systemic lupus erythematosus SIR = 2.21, and ulcerative colitis SIR = 2.15.

ConclusionsHospitalization for many IMDs is associated with increased risk of ischemic or hemorrhagic stroke. The findings suggest that several IMDs are linked to cerebrovascular disease.

AbbreviationsCIConfidence interval

EExpected

ICDinternational classification of diseases

IMDimmune-mediated disease

OObserved

RArheumatoid arthritis

SESsocioeconomic status

SIRstandarized incidence ratio

SLEsystemic lupus erythematosus.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-12-41 contains supplementary material, which is available to authorized users.

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Autor: Bengt Zöller - Xinjun Li - Jan Sundquist - Kristina Sundquist

Fuente: https://link.springer.com/







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