title: Risk of ischemic stroke in patients with systemic sclerosis: A systematic review and meta-analysis.
abstract: BACKGROUND
  Several chronic inflammatory disorders, such as rheumatoid arthritis and idiopathic inflammatory myositis, have been shown to increase risk of ischemic stroke but the data on systemic sclerosis (SSc) remains unclear.
  
  
  METHODS
  We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing risk of ischemic stroke in patients with SSc versus non-SSc participants. Pooled risk ratio and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.
  
  
  RESULTS
  Four retrospective cohort studies were identified and included in our data analysis. We found a statistically significant elevated ischemic stroke risk in patients with SSc with a pooled risk ratio of 1.68 (95% CI, 1.26-2.24). The statistical heterogeneity was moderate with an I(2) of 69%.
  
  
  CONCLUSIONS
  Our study demonstrated a statistically significant increased ischemic stroke risk among patients with SSc.
authors.affiliation: a Division of Rheumatology, Department of Internal Medicine , Mayo Clinic , Rochester , MN , USA.|b Department of Medicine , Faculty of Medicine Siriraj hospital, Mahidol University , Bangkok , Thailand.
authors.forename: Patompong
authors.initials: P
authors.lastname: Ungprasert
authors.affiliation: c Department of Preventive and Social Medicine , Faculty of medicine Siriraj hospital, Mahidol University , Bangkok , Thailand.
authors.forename: Anawin
authors.initials: A
authors.lastname: Sanguankeo
authors.affiliation: c Department of Preventive and Social Medicine , Faculty of medicine Siriraj hospital, Mahidol University , Bangkok , Thailand.
authors.forename: Sikarin
authors.initials: S
authors.lastname: Upala
mesh_terms: D002545:Brain Ischemia / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D015994:Incidence; D009220:Myositis / Q000150:complications; D012306:Risk; D012595:Scleroderma, Systemic / Q000150:complications*; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology
keywords: Epidemiology; Inflammation; Meta-analysis; Stroke; Systemic sclerosis