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Increased risk of stroke among patients with ulcerative colitis: a population-based matched cohort study
Joseph J Keller1, Jui Wang, Ya-Li Huang
1School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
Insights
Patients with ulcerative colitis (UC) face a doubled risk of subsequent stroke, particularly those over 50. This finding highlights the importance of stroke risk assessment in UC patients.
Area of Science:
- Gastroenterology
- Neurology
- Epidemiology
Background:
- Inflammatory bowel disease (IBD), including ulcerative colitis (UC), is linked to increased risks of venous thromboembolism and atherosclerosis.
- The association between UC and stroke risk remains controversial in existing literature.
Purpose of the Study:
- To investigate the risk of subsequent stroke in patients diagnosed with ulcerative colitis (UC).
- To compare stroke risk in UC patients versus a matched cohort without IBD using population-based data.
Main Methods:
- Analysis of administrative claims data from Taiwan's National Health Insurance Database.
- Inclusion of 516 UC patients and 2,579 IBD-free comparison subjects.
- Utilized Cox proportional hazards regressions to assess stroke risk, with subgroup analyses by age and gender.
Main Results:
- Adjusted analyses revealed a 2.045-fold increased hazard ratio (HR) for subsequent stroke in UC patients compared to controls.
- Increased stroke risk was significant for UC patients over 50 years old.
- The association remained significant in both men (HR=2.153) and women (HR=2.750).
Conclusions:
- This cohort study identified a significantly elevated risk of subsequent stroke among Taiwanese UC patients.
- The findings underscore the need for vigilance regarding cerebrovascular events in the UC population.
Background:
The risk of venous thromboembolism (VTE) and the development of atherosclerosis are increased in patients with inflammatory bowel disease (IBD). Ulcerative colitis (UC) is one type of IBD; however, there is controversy in the literature regarding the association between UC and stroke. The present cohort study estimated the risk of subsequent stroke among UC patients compared with that among matched comparison subjects drawn from a population-based data set in Taiwan.
Methods:
This investigation analyzed administrative claims data sourced from the Taiwan National Health Insurance Database. Our study consisted of a study cohort comprising 516 UC patients and a comparison cohort of 2,579 subjects without IBD. Cox proportional hazards regressions were performed to estimate the risk of subsequent stroke during the follow-up period. We also conducted additional analyses investigating the risk of subsequent stroke by age group and gender.
Results:
After adjusting for selected medical co-morbidities and recent prescriptions of selected pharmaceuticals, the hazard ratio (HR) for subsequent stroke among patients with UC was 2.045 (95 % confidence interval (CI) = 1.374-3.043) than that among comparison subjects. While we did not detect an association between stroke and UC among patients aged 30-40 or 40-50 years, we did detect increased risks for stroke among UC patients aged over 50 years (HR = 2.045). We also found the association to remain significant for both men (HR = 2.153) and women (HR = 2.750).
Conclusions:
This study detected an increased HR for subsequent stroke among Taiwanese UC patients hen compared to that among matched comparison patients without IBD.
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