Increased risk of ischemic stroke in patients with systemic lupus erythematosus: a nationwide population-based study.
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.


CONCLUSIONS
Patients with SLE have an increased risk of stroke.
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taiwan, ROC.
Chun-Chih
CC
Chiu
Chin-Chou
CC
Huang
Wan-Leong
WL
Chan
Chia-Min
CM
Chung
Po-Hsun
PH
Huang
Shing-Jong
SJ
Lin
Jaw-Wen
JW
Chen
Hsin-Bang
HB
Leu
D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D013624:Taiwan / Q000453:epidemiology