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Risk of ischemic stroke in patients with systemic sclerosis: A systematic review and meta-analysis

Patompong Ungprasert1,2, Anawin Sanguankeo3, Sikarin Upala3

  • 1a Division of Rheumatology, Department of Internal Medicine , Mayo Clinic , Rochester , MN , USA.

Modern Rheumatology
|May 31, 2015
PubMed

Insights

Systemic sclerosis (SSc) patients face a significantly higher risk of ischemic stroke. This meta-analysis confirms an elevated stroke risk in individuals with SSc, highlighting a critical health concern.

Area of Science:

  • Rheumatology
  • Neurology
  • Epidemiology

Background:

  • Chronic inflammatory disorders like rheumatoid arthritis and idiopathic inflammatory myositis are known risk factors for ischemic stroke.
  • The association between systemic sclerosis (SSc) and ischemic stroke risk is not well-established.
  • Understanding SSc's impact on stroke risk is crucial for patient management.

Purpose of the Study:

  • To systematically review and meta-analyze observational studies on the risk of ischemic stroke in patients with SSc.
  • To quantify the association between SSc and ischemic stroke using pooled risk ratios.
  • To clarify the unclear data regarding SSc and its link to ischemic stroke.

Main Methods:

  • Systematic review and meta-analysis of four retrospective cohort studies.
  • Inclusion criteria: observational studies reporting risk estimates (OR, RR, HR, SIR) comparing SSc patients to non-SSc controls.
  • Pooled risk ratio and 95% confidence intervals (CIs) calculated using a random-effect model.

Main Results:

  • A statistically significant elevated risk of ischemic stroke was found in SSc patients.
  • The pooled risk ratio for ischemic stroke in SSc patients was 1.68 (95% CI, 1.26-2.24).
  • Moderate statistical heterogeneity was observed (I² = 69%).

Conclusions:

  • Systemic sclerosis is associated with a statistically significant increased risk of ischemic stroke.
  • The findings underscore the importance of considering cerebrovascular risk in SSc management.
  • Further research may explore specific SSc subtypes or mechanisms contributing to stroke risk.
Abstract

Keywords:
EpidemiologyInflammationMeta-analysisStrokeSystemic sclerosis

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