Healthcare and Management Center, Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan, No. 201, Sec. 2, Shi-Pai Road, Taipei, Taiwan, R.O.C.
Rheumatology (Oxford). 2013 Jan;52(1):161-5. doi: 10.1093/rheumatology/kes352.
To investigate whether SSc increases the risk of ischaemic stroke in a large, nationwide cohort study.
From the Registry of Catastrophic Illness in Taiwan, we obtained data for 1280 patients with a diagnosis of SSc from 1997 to 2006. We also obtained data for 10 age-, gender-, comorbidity- and enrolment date-matched controls per SSc patient from the Longitudinal Health Insurance 2000. All study subjects were followed up from the date of enrolment until they developed ischaemic stroke, death or to the end of 2006, whichever was earlier. We used Cox's regression model with adjustment for age, gender and comorbid disorders to assess the independent factors in determining the risk of developing ischaemic stroke.
We identified 1238 SSc patients and 12 380 controls. Among these patients, 765 (86 SSc patients and 679 controls) had developed ischaemic stroke during the median 4.7 years (0.1-10.0 years) of follow-up. Patients with SSc had a significantly higher incidence of ischaemic stroke when compared with controls (16.5/1000 vs 11.5/1000 person-year). After multivariate analysis, SSc was associated with a 43% increase in ischaemic stroke risk (95% CI 12%, 83%; P = 0.004). Additionally, the medication usually being prescribed among SSc patients did not alter the risk of further ischaemic stroke.
We conclude that SSc is independently associated with higher risk of ischaemic stroke development.
在一项大型全国队列研究中，探讨是否硬皮病会增加缺血性中风的风险。
我们从台湾灾难性疾病登记处获得了 1997 年至 2006 年期间 1280 例硬皮病患者的数据。我们还从 2000 年纵向健康保险中获得了每例硬皮病患者 10 名年龄、性别、合并症和登记日期匹配的对照者的数据。所有研究对象均从登记日期开始随访，直到发生缺血性中风、死亡或 2006 年底（以先发生者为准）。我们使用 Cox 回归模型，调整年龄、性别和合并症等因素，评估确定发生缺血性中风风险的独立因素。
我们共确定了 1238 例硬皮病患者和 12380 例对照者。在这些患者中，765 例（86 例硬皮病患者和 679 例对照者）在中位 4.7 年（0.1-10.0 年）的随访期间发生了缺血性中风。与对照者相比，硬皮病患者发生缺血性中风的发生率显著更高（16.5/1000 与 11.5/1000 人年）。经过多变量分析，硬皮病与缺血性中风风险增加 43%相关（95%CI 12%，83%；P=0.004）。此外，硬皮病患者常用的药物并不能改变进一步发生缺血性中风的风险。
我们的结论是，硬皮病与缺血性中风发生风险增加独立相关。
