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Relationship between patients with atopic dermatitis and the incidence of stroke: A systematic review with
Luiz Carlos Figueiredo Filho1, Ricardo Ormanes Massoud1, Rafael Augusto Silva Cabeça1
1Faculty of Medicine, State University of Pará (UEPA), Belém, Pará, Brazil.
Background:
Atopic dermatitis (AD) is a chronic inflammatory skin condition associated with a variety of comorbidities, including cardiovascular and mental health issues. Recent studies have suggested a potential link between AD and an increased risk of stroke, particularly ischemic stroke. However, the association remains unclear, warranting further investigation.
Methods:
This study conducted a systematic review and meta-analysis to explore the relationship between AD and stroke risk. PRISMA guidelines were followed, and a comprehensive search was carried out in multiple databases, including PubMed/MEDLINE, Biblioteca Virtual em Saúde (BVS), Embase, Cochrane, Web of Science, and Scopus. Observational studies reporting on the incidence of stroke in patients with AD were included. A meta-analysis was performed to assess the odds ratio (OR), hazard ratio (HR), and relative risk (RR) for stroke incidence. Heterogeneity and publication bias were evaluated using Cochran's Q test, I² statistic, and funnel plots.
Results:
A total of 11 studies were included, with the majority being cohort studies. The meta-analysis revealed a significant association between AD and an increased risk of ischemic stroke, with an HR of 1.19 (95 % CI 1.13-1.26, p < 0.00001) and moderate heterogeneity (I² = 57 %). However, no statistically significant increase in hemorrhagic stroke risk was observed (HR = 1.13, 95 % CI 1-1.29, p = 0.06). Patients with severe AD exhibited a higher stroke risk compared to those with mild AD, with ORs of 1.29 (95 % CI 1.07-1.56) and 1.06 (95 % CI 0.88-1.27), respectively.
Conclusions:
This meta-analysis confirms a significant association between AD and ischemic stroke, particularly in patients with severe AD. Further research is needed to understand this relationship better and explore potential preventative strategies, including the role of AD treatment in reducing stroke risk.
