title: Systemic sclerosis and risk of ischaemic stroke: a nationwide cohort study.
abstract: OBJECTIVE
  To investigate whether SSc increases the risk of ischaemic stroke in a large, nationwide cohort study.
  
  
  METHODS
  From the Registry of Catastrophic Illness in Taiwan, we obtained data for 1280 patients with a diagnosis of SSc from 1997 to 2006. We also obtained data for 10 age-, gender-, comorbidity- and enrolment date-matched controls per SSc patient from the Longitudinal Health Insurance 2000. All study subjects were followed up from the date of enrolment until they developed ischaemic stroke, death or to the end of 2006, whichever was earlier. We used Cox's regression model with adjustment for age, gender and comorbid disorders to assess the independent factors in determining the risk of developing ischaemic stroke.
  
  
  RESULTS
  We identified 1238 SSc patients and 12 380 controls. Among these patients, 765 (86 SSc patients and 679 controls) had developed ischaemic stroke during the median 4.7 years (0.1-10.0 years) of follow-up. Patients with SSc had a significantly higher incidence of ischaemic stroke when compared with controls (16.5/1000 vs 11.5/1000 person-year). After multivariate analysis, SSc was associated with a 43% increase in ischaemic stroke risk (95% CI 12%, 83%; P = 0.004). Additionally, the medication usually being prescribed among SSc patients did not alter the risk of further ischaemic stroke.
  
  
  CONCLUSIONS
  We conclude that SSc is independently associated with higher risk of ischaemic stroke development.
authors.affiliation: Healthcare and Management Center, Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, No. 201, Sec. 2, Shi-Pai Road, Taipei, Taiwan, R.O.C.  hbleu@vghtpe.gov.tw.
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Chiang
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.forename: Wan-Leong
authors.initials: WL
authors.lastname: Chan
authors.forename: Po-Hsun
authors.initials: PH
authors.lastname: Huang
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Chia-Min
authors.initials: CM
authors.lastname: Chung
authors.forename: Shing-Jong
authors.initials: SJ
authors.lastname: Lin
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
authors.forename: Hsin-Bang
authors.initials: HB
authors.lastname: Leu
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012306:Risk; D012595:Scleroderma, Systemic / Q000453:epidemiology*; D020521:Stroke / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology