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Risk of Stroke in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Zhilong Xiao1, Zhimin Pei2, Min Yuan1
1Department of Neurology, The Second Affiliated Hospital of Nanchang University, Jiangxi Province, China.
Objective:
Observational studies, to date, have provided inconsistent findings on whether inflammatory bowel disease (IBD) is associated with an increased risk of stroke. We therefore performed a meta-analysis to evaluate the association of IBD and its specific subtypes with risk of stroke.
Design:
We searched electronic databases for studies through May 13, 2015 assessing risk of stroke in patients with IBD. Cohort and case-control studies that reported incident cases of stroke in patients with IBD and a non-IBD control population were eligible. We calculated pooled hazard ratios (HRs) with 95% confidence intervals (CIs).
Results:
A total of 8 articles (126,493 IBD patients and 4748 cases of stroke) were included in this meta-analysis. The presence of IBD revealed a trend toward a modest increase in the risk of stroke incidence (HR = 1.29; 95% CI, 1.16-1.43). After subgroup analysis, Crohn's disease showed an increased risk of stroke incidence (7 studies: HR = 1.32; 95% CI, 1.13-1.56), and a significant association was also identified in ulcerative colitis (6 studies: HR = 1.18; 95% CI, 1.06-1.31). In addition, this risk is higher in women (6 studies: HR = 1.49; 95% CI, 1.24-1.79) than in men (HR = 1.22; 95% CI, 1.12-1.32). In the overall analysis we found considerable heterogeneity.
Conclusion:
Our results show a positive association between IBD and the risk of stroke.
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