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Increased risk of stroke among patients with Crohn's disease: a population-based matched cohort study
Joseph Jordan Keller1, Jui Wang, Ya-Li Hwang
1School of Public Health, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan.
Insights
Patients with Crohn's disease (CD) have a nearly double risk of subsequent stroke. This risk is higher in women and older adults, highlighting a critical link between IBD and cerebrovascular events.
Area of Science:
- Gastroenterology and Neurology
- Epidemiology and Public Health
Background:
- Crohn's disease (CD), a type of inflammatory bowel disease (IBD), may share prognostic factors with stroke development.
- Existing literature presents controversial findings on the association between CD and stroke.
- This study investigates the risk of subsequent stroke in CD patients within an Asian population.
Purpose of the Study:
- To estimate the risk of subsequent stroke in individuals diagnosed with Crohn's disease.
- To compare stroke incidence in CD patients versus a matched cohort without IBD.
- To analyze stroke risk stratification by age and gender in CD patients.
Main Methods:
- A historical cohort study utilizing the Taiwan National Health Insurance Database.
- Inclusion of 3309 CD patients and 13,236 matched comparison subjects without IBD.
- Application of Cox proportional hazards regressions, with adjustments for comorbidities and pharmaceuticals, and stratified analyses by age and gender.
Main Results:
- Adjusted hazard ratio (HR) for subsequent stroke in CD patients was 1.911 (95% CI: 1.65-2.22) compared to controls.
- Increased stroke risk was observed in CD patients aged 40-50 (HR=2.29) and over 50 (HR=1.88), but not in the 30-40 age group.
- Women with CD exhibited a higher risk of stroke (HR=2.39) than men (HR=1.50).
Conclusions:
- This population-based cohort study confirms an elevated risk of subsequent stroke among patients with Crohn's disease in Taiwan.
- The findings underscore a significant association between IBD and cerebrovascular disease, particularly in specific demographic groups.
- Further research into the underlying mechanisms and preventative strategies for stroke in CD patients is warranted.
Background:
Crohn's disease (CD) is one type of inflammatory bowel disease (IBD) that has been speculated to share prognostic factors with the development of stroke. There is controversial information in the literature regarding the association between CD and stroke. The present cohort study estimated the risk of subsequent stroke among CD patients compared with matched comparison subjects drawn from a population-based dataset in Taiwan.
Method:
This study drew data from the Taiwan National Health Insurance Database to conduct a historical cohort study. The study cohort comprised 3309 CD patients, and the comparison cohort comprised 13,236 subjects without an IBD. Cox proportional hazards regressions were performed to estimate the risk of subsequent stroke during the follow-up period. We also conducted additional analyses stratifying 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 CD was found to be 1.911 (95% confidence interval (CI) = 1.65-2.22) that of comparison subjects. While we did not detect an association between stroke and CD among patients aged 30-40 years, we did detect increased risks for stroke among CD patients aged 40-50 years (HR = 2.29) and those aged over 50 years (HR = 1.88). We also found women (HR = 2.39) to be at a greater risk than men (HR = 1.50).
Conclusion:
This study reports an increased HR for subsequent stroke among CD patients when compared to matched comparison patients without IBD in an Asian population.
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