Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.
BACKGROUND
Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS) in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS.


METHODS
A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates.


RESULTS
During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p = 0.0021). The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20-3.29; p = 0.0079) and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16-3.20; p = 0.0110).


CONCLUSIONS
Our study showed an increased risk of developing ischemic stroke in young patients with AS.
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Chia-Wei
CW
Lin
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Yu-Lin Branch, Yunlin, Taiwan.
Ya-Ping
YP
Huang
Department and Graduate Institute of Health Care Management, Chang Gung University, Tao-Yuan, Taiwan.
Yueh-Hsia
YH
Chiu
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Yu-Tsun
YT
Ho
Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan.
Shin-Liang
SL
Pan
D000293:Adolescent; D000328:Adult; D002545:Brain Ischemia / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012306:Risk; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000209:etiology*; D015996:Survival Rate; D055815:Young Adult