title: Stroke and Transient Ischemic Attack in Takayasu's Arteritis: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  Cerebrovascular disease is one of the possible consequences of Takayasu's arteritis (TA). However, little is known about the prevalence of stroke/transient ischemic attack (TIA) or its related clinical features among these patients. We have performed a systematic review and meta-analysis to estimate the rate and risk factors of stroke/TIA in TA as well as to explore associations with poorer outcomes.
  
  
  METHODS
  MEDLINE and Embase were searched (October 2014) for observational studies of any design reporting prevalence rates of stroke/TIA among TA patients. Study selection, data collection, and quality assessment were done independently. Studies' results were pooled through random-effect meta-analysis. Heterogeneity was assessed with the I(2) test.
  
  
  RESULTS
  Twenty-one studies (16 studies were of cohort design) were included (n = 3269). The pooled stroke/TIA prevalence rate estimate was 15.8% (95% confidence interval [CI]: 10.7%-22.6%, I(2) = 94%). Sensitivity analysis, excluding 8 studies with poorer TA diagnostic criteria, yielded a similar estimate but without statistical heterogeneity (15.7%; 95% CI: 13.6%-18.1%, I(2) = 5.5%). Data were unavailable to explore possible associations between patients' characteristics and stroke/TIA prevalence.
  
  
  CONCLUSIONS
  Our results document a high prevalence of stroke/TIA among TA patients. However, there is scarce information on the type of stroke, the characteristics of the affected individuals, and stroke-associated morbidity and mortality. Future studies should aim to further explore this disabling complication to find the best treatment and prevention strategies.
authors.affiliation: Center for Evidence Based Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal. Electronic address: martas@campus.ul.pt.
authors.forename: Marta M
authors.initials: MM
authors.lastname: Duarte
authors.affiliation: Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom; Anatomy Department, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
authors.forename: Ruth
authors.initials: R
authors.lastname: Geraldes
authors.affiliation: Center for Evidence Based Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Portuguese Collaborating Center of the IberoAmerican Cochrane Network, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Sousa
authors.affiliation: Center for Evidence Based Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Portuguese Collaborating Center of the IberoAmerican Cochrane Network, Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Alarcão
authors.affiliation: Center for Evidence Based Medicine, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Portuguese Collaborating Center of the IberoAmerican Cochrane Network, Faculty of Medicine, University of Lisbon, Lisbon, Portugal; Clinical Pharmacology Unit, Instituto de Medicina Molecular, Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Costa
mesh_terms: D000818:Animals; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D006801:Humans; D002546:Ischemic Attack, Transient / Q000453:epidemiology* / Q000209:etiology*; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology*; D013625:Takayasu Arteritis / Q000150:complications*
keywords: TIA; Takayasu's arteritis; aortic arch syndrome; aortitis; cerebrovascular; large-vessel vasculitis; pulseless disease; stroke