Department of Social and Clinical Pharmacy, Faculty of Pharmacy at Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
Cardiff School of Technologies, Cardiff Metropolitan University, Cardiff, UK; Collaboration for the Advancement of Sustainable Medical Innovation, University College London, London, UK.
Reumatol Clin (Engl Ed). 2023 Mar;19(3):136-142. doi: 10.1016/j.reumae.2023.02.002.
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.
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.
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).
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.
强直性脊柱炎是一种慢性炎症性疾病，与不良心血管事件相关。本研究旨在确定强直性脊柱炎与中风风险之间的关系。
从建库至 2021 年 12 月，我们在 PubMed/MEDLINE、Scopus 和 Web of Science 中进行了系统的文献检索，以确定调查强直性脊柱炎患者中风风险的相关文章。我们使用随机效应模型（DerSimonian 和 Laird）来估计合并危险比（HR）和 95%置信区间（CI）。我们进行了基于随访时间的meta 回归和基于中风类型、研究地点和发表年份的亚组分析，以探究异质性的来源。
本研究共纳入了 11 项研究，涵盖了 170 万名参与者。汇总分析显示，强直性脊柱炎患者的中风风险显著增加（56%）（HR：1.56，95%CI 1.33-1.79）。亚组分析显示，强直性脊柱炎患者发生缺血性中风的风险更高（HR：1.46，95%CI：1.23-1.68）。然而，meta 回归分析显示，强直性脊柱炎的病程与中风发生率之间无关联（Coef=-0.0010，P=0.951）。
本研究表明，强直性脊柱炎与中风风险增加相关。在强直性脊柱炎患者中，应考虑管理脑血管危险因素和控制全身炎症。
