Increased risk of stroke among patients with ankylosing spondylitis: A systematic review and meta-analysis.

Humans Spondylitis, Ankylosing / complications Risk Factors
Accidente cerebrovascular Ankylosing spondylitis Cerebrovascular accident Espondilitis anquilosante Hazard ratio Ictus Relación de peligro Revisión sistemática de metaanálisis Riesgo Risk Stroke Systematic review meta-analysis

Journal

Reumatologia clinica
ISSN: 2173-5743
Titre abrégé: Reumatol Clin (Engl Ed)
Pays: Spain
ID NLM: 101717526

Informations de publication

Date de publication:
Mar 2023
Historique:
received: 09 09 2021
accepted: 28 04 2022
entrez: 11 3 2023
pubmed: 12 3 2023
medline: 15 3 2023
Statut: ppublish

Résumé

Ankylosing spondylitis is a chronic inflammatory disease that is associated with adverse cardiovascular events. This study aimed to determine the relationship between ankylosing spondylitis and the risk of stroke. A systematic literature search in PubMed/MEDLINE, Scopus, and Web of Science were conducted from inception to December 2021 to identify relevant articles investigating the risk of stroke in patients with ankylosing spondylitis. A random-effects model (DerSimonian and Laird) was used to estimate a pooled hazard ratio (HR) and 95% confidence intervals (CI). Meta-regression based on the length of follow-up and subgroup analysis based on the type of stroke, study location, and year of publication to investigate the source of heterogeneity. A total of eleven studies comprising 1.7 million participants were included in this study. Pooled analysis showed a significantly increased stroke risk (56%) among patients with ankylosing spondylitis (HR: 1.56, 95% CI 1.33-1.79). Subgroup analysis revealed a higher risk of ischemic stroke among patients with ankylosing spondylitis (HR: 1.46, 95% CI: 1.23-1.68). However, meta-regression analysis showed no association between the duration of ankylosing spondylitis and stroke incidence (Coef=-0.0010, P=0.951). This study reveals that ankylosing spondylitis was associated with an increased risk of suffering a stroke. Management of cerebrovascular risk factors and the control of systemic inflammation should be considered in patients with ankylosing spondylitis.

Sections du résumé

BACKGROUND BACKGROUND
Ankylosing spondylitis is a chronic inflammatory disease that is associated with adverse cardiovascular events. This study aimed to determine the relationship between ankylosing spondylitis and the risk of stroke.
METHODS METHODS
A systematic literature search in PubMed/MEDLINE, Scopus, and Web of Science were conducted from inception to December 2021 to identify relevant articles investigating the risk of stroke in patients with ankylosing spondylitis. A random-effects model (DerSimonian and Laird) was used to estimate a pooled hazard ratio (HR) and 95% confidence intervals (CI). Meta-regression based on the length of follow-up and subgroup analysis based on the type of stroke, study location, and year of publication to investigate the source of heterogeneity.
RESULTS RESULTS
A total of eleven studies comprising 1.7 million participants were included in this study. Pooled analysis showed a significantly increased stroke risk (56%) among patients with ankylosing spondylitis (HR: 1.56, 95% CI 1.33-1.79). Subgroup analysis revealed a higher risk of ischemic stroke among patients with ankylosing spondylitis (HR: 1.46, 95% CI: 1.23-1.68). However, meta-regression analysis showed no association between the duration of ankylosing spondylitis and stroke incidence (Coef=-0.0010, P=0.951).
CONCLUSION CONCLUSIONS
This study reveals that ankylosing spondylitis was associated with an increased risk of suffering a stroke. Management of cerebrovascular risk factors and the control of systemic inflammation should be considered in patients with ankylosing spondylitis.

Identifiants

DOI: 10.1016/j.reumae.2023.02.002 PMID: 36906389
pubmed: 36906389
pii: S2173-5743(23)00016-3
doi: 10.1016/j.reumae.2023.02.002
pii:
doi:

Types de publication

Meta-Analysis Systematic Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

136-142

Informations de copyright

Copyright © 2022 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

Auteurs

Akshaya Srikanth Bhagavathula (AS)

Department of Social and Clinical Pharmacy, Faculty of Pharmacy at Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.

Barry L Bentley (BL)

Cardiff School of Technologies, Cardiff Metropolitan University, Cardiff, UK; Collaboration for the Advancement of Sustainable Medical Innovation, University College London, London, UK.

Benjamin Woolf (B)

Department of Psychological Sciences, University of Bristol, Bristol BS8 1TH, UK.

Thusharika D Dissanayaka (TD)

Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka; Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia.

Jamal Rahmani (J)

Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: jrahmani@sbmu.ac.ir.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Increased risk of stroke among patients with...
questionsmedicales.fr › Maladies ostéomusculaires › Maladies articulaires › Arthrite › Spondylarthrite › Spondylarthropathies › Spondyloarthrite axiale › Pelvispondylite rhumatismale › Increased risk of stroke among patients with...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Increased risk of stroke among patients with...