TY - JOUR
T1 - Increased risk of stroke among patients with ankylosing spondylitis
T2 - A systematic review and meta-analysis
AU - Bhagavathula, Akshaya Srikanth
AU - Bentley, Barry L.
AU - Woolf, Benjamin
AU - Dissanayaka, Thusharika D.
AU - Rahmani, Jamal
N1 - Publisher Copyright:
© 2022 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología
PY - 2023/3/6
Y1 - 2023/3/6
N2 - Background: Ankylosing spondylitis is a chronic inflammatory disease that is associated with adverse cardiovascular events. This study aimed to determine the relationship between ankylosing spondylitis and the risk of stroke. Methods: A systematic literature search in PubMed/MEDLINE, Scopus, and Web of Science were conducted from inception to December 2021 to identify relevant articles investigating the risk of stroke in patients with ankylosing spondylitis. A random-effects model (DerSimonian and Laird) was used to estimate a pooled hazard ratio (HR) and 95% confidence intervals (CI). Meta-regression based on the length of follow-up and subgroup analysis based on the type of stroke, study location, and year of publication to investigate the source of heterogeneity. Results: A total of eleven studies comprising 1.7 million participants were included in this study. Pooled analysis showed a significantly increased stroke risk (56%) among patients with ankylosing spondylitis (HR: 1.56, 95% CI 1.33–1.79). Subgroup analysis revealed a higher risk of ischemic stroke among patients with ankylosing spondylitis (HR: 1.46, 95% CI: 1.23–1.68). However, meta-regression analysis showed no association between the duration of ankylosing spondylitis and stroke incidence (Coef = −0.0010, P = 0.951). Conclusion: This study reveals that ankylosing spondylitis was associated with an increased risk of suffering a stroke. Management of cerebrovascular risk factors and the control of systemic inflammation should be considered in patients with ankylosing spondylitis.
AB - Background: Ankylosing spondylitis is a chronic inflammatory disease that is associated with adverse cardiovascular events. This study aimed to determine the relationship between ankylosing spondylitis and the risk of stroke. Methods: A systematic literature search in PubMed/MEDLINE, Scopus, and Web of Science were conducted from inception to December 2021 to identify relevant articles investigating the risk of stroke in patients with ankylosing spondylitis. A random-effects model (DerSimonian and Laird) was used to estimate a pooled hazard ratio (HR) and 95% confidence intervals (CI). Meta-regression based on the length of follow-up and subgroup analysis based on the type of stroke, study location, and year of publication to investigate the source of heterogeneity. Results: A total of eleven studies comprising 1.7 million participants were included in this study. Pooled analysis showed a significantly increased stroke risk (56%) among patients with ankylosing spondylitis (HR: 1.56, 95% CI 1.33–1.79). Subgroup analysis revealed a higher risk of ischemic stroke among patients with ankylosing spondylitis (HR: 1.46, 95% CI: 1.23–1.68). However, meta-regression analysis showed no association between the duration of ankylosing spondylitis and stroke incidence (Coef = −0.0010, P = 0.951). Conclusion: This study reveals that ankylosing spondylitis was associated with an increased risk of suffering a stroke. Management of cerebrovascular risk factors and the control of systemic inflammation should be considered in patients with ankylosing spondylitis.
KW - Ankylosing spondylitis
KW - Cerebrovascular accident
KW - Hazard ratio
KW - Risk
KW - Stroke
KW - Systematic review meta-analysis
UR - https://www.scopus.com/pages/publications/85131578385
U2 - 10.1016/j.reuma.2022.04.001
DO - 10.1016/j.reuma.2022.04.001
M3 - Article
AN - SCOPUS:85131578385
SN - 1699-258X
VL - 19
SP - 136
EP - 142
JO - Reumatologia Clinica
JF - Reumatologia Clinica
IS - 3
ER -