Department of Medicine "B", Sheba Medical Center, Tel-Hashomer, Israel.
Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel.
Neuroepidemiology. 2017;49(3-4):99-105. doi: 10.1159/000481992. Epub 2017 Nov 14.
BACKGROUND/AIMS: Rheumatoid arthritis (RA) is a chronic, debilitating autoimmune disease that affects the joints and it is known to be associated with cardiovascular morbidity. However, the association between RA and stroke among different age groups has not been explored. The objective of our study was to evaluate the association between RA and stroke in different age strata.
Cross-sectional study, utilizing the database of Israel's largest healthcare provider. The proportion of stroke was compared between patients diagnosed with RA and age- and gender-matched controls. The study sample was divided into 2 age groups: young (≤65 years) and elderly (>65 years). Multivariable analysis was performed using logistic regression.
The study included 11,782 RA patients and 57,973 age- and gender-matched controls. RA patients, primarily young, had more cardiovascular risk factors than controls. Stroke rates were significantly elevated among young RA patients in comparison with controls (3.74 vs. 2.20%, respectively, p < 0.001). In multivariate analysis, RA was found to be independently associated with stroke (OR 1.18, 95% CI 1.09-1.28).
RA is independently associated with stroke, especially among RA patients under 65 years, for whom cardiovascular risk factors were more prominent. Physicians should advise RA patients to manage their risk factors strictly.
背景/目的：类风湿关节炎（RA）是一种慢性、使人虚弱的自身免疫性疾病，影响关节，已知与心血管发病率有关。然而，RA 与不同年龄组中风之间的关联尚未被探索。我们的研究目的是评估 RA 与不同年龄组中风之间的关联。
使用以色列最大医疗保健提供商的数据库进行横断面研究。比较了诊断为 RA 的患者和年龄及性别匹配的对照组中中风的比例。研究样本分为 2 个年龄组：年轻（≤65 岁）和老年（>65 岁）。使用逻辑回归进行多变量分析。
研究纳入了 11782 名 RA 患者和 57973 名年龄及性别匹配的对照组。RA 患者主要为年轻人，比对照组有更多的心血管危险因素。与对照组相比，年轻 RA 患者的中风发生率显著升高（分别为 3.74%和 2.20%，p<0.001）。多变量分析发现，RA 与中风独立相关（OR 1.18，95%CI 1.09-1.28）。
RA 与中风独立相关，尤其是在 65 岁以下的 RA 患者中，这些患者的心血管危险因素更为突出。医生应建议 RA 患者严格管理其危险因素。
