Polymyalgia rheumatica and risk of cerebrovascular accident: A systematic review and meta-analysis.
BACKGROUND
Several chronic inflammatory disorders, such as rheumatoid arthritis and systemic lupus erythematosus, have been linked to an increased risk of cerebrovascular accident (CVA), but the data on polymyalgia rheumatica (PMR) 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 the risk of CVA in patients with PMR versus non-PMR controls. Pooled risk ratio and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.


RESULTS
Three retrospective cohort studies and one cross-sectional study were identified and included in the data analysis. We found a significantly elevated CVA risk in patients with PMR, with the pooled risk ratio of 1.87 (95% CI, 1.43-2.43). The statistical heterogeneity was high, with an I2 of 91%.


CONCLUSIONS
Our study demonstrated a statistically significantly increased CVA risk among patients with PMR.
Department of Internal Medicine, Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA; Department of Medicine, Division of Rheumatology, Siriraj Hospital, Mahidol University, Bangkok, Thailand, .
Patompong
P
Ungprasert
Division of Pulmonology and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Narat
N
Srivali
Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
Charat
C
Thongprayoon
D006801:Humans; D064887:Observational Studies as Topic; D011111:Polymyalgia Rheumatica / Q000150:complications*; D012307:Risk Factors; D020521:Stroke / Q000150:complications*