Rheumatoid arthritis significantly increased recurrence risk after ischemic stroke/transient ischemic attack

Yih Ru Chen, Fang I. Hsieh, Li Ming Lien, Chaur Jong Hu, Jiann Shing Jeng, Giia Sheun Peng, Sung Chun Tang, Nai Fang Chi, Yueh Feng Sung, Hung Yi Chiou

研究成果: 雜誌貢獻文章

3 引文 (Scopus)

摘要

The effect of RA on recurrent stroke is unknown. Therefore, we examined effects of rheumatoid arthritis (RA) on risk of stroke recurrence and investigated the interaction between RA and traditional cardiovascular risk factors on recurrence risk after ischemic stroke (IS) or transient ischemic attack (TIA). Of 3190 patients with IS or TIA recruited in this cohort study, 638 were comorbid with RA and 2552 without RA. Stroke recurrence, RA, lifestyle, lipid variables and other comorbidities were identified through linkage between a nationwide stroke database in Taiwan and the National Health Insurance claims database. Cox proportional hazard models with competing risk adjustment were used to evaluate the relationship between RA and recurrent stroke. Patients with RA showed a significantly increased risk of recurrent stroke, particular in recurrent IS/TIA. The increased risk of recurrent IS/TIA in RA patients may through the changes of triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) ratio. A positive additive interaction was observed between RA and current smoking on the risk of recurrent IS/TIA. Significantly increased risks for recurrent IS/TIA were observed among RA patients who smoked > 40 years or those who smoked > 20 cigarettes/day. This study provides the first evidence that RA significantly increased recurrence IS/TIA risk. The changes of TG/HDL-C ratio may play some roles in the recurrence IS/TIA risk in RA patients. In addition, our results suggest that smoking increases the risk of recurrent IS/TIA in RA patients and reinforces the need for aggressive smoking cessation efforts in RA patients.
原文英語
頁(從 - 到)1810-1818
頁數9
期刊Journal of Neurology
265
發行號8
DOIs
出版狀態已發佈 - 八月 1 2018

指紋

Transient Ischemic Attack
Rheumatoid Arthritis
Stroke
Recurrence
HDL Cholesterol
Triglycerides
Smoking
Databases
Risk Adjustment
National Health Programs
Smoking Cessation
Taiwan
Proportional Hazards Models
Tobacco Products
Life Style
Comorbidity

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

引用此文

Rheumatoid arthritis significantly increased recurrence risk after ischemic stroke/transient ischemic attack. / Chen, Yih Ru; Hsieh, Fang I.; Lien, Li Ming; Hu, Chaur Jong; Jeng, Jiann Shing; Peng, Giia Sheun; Tang, Sung Chun; Chi, Nai Fang; Sung, Yueh Feng; Chiou, Hung Yi.

於: Journal of Neurology, 卷 265, 編號 8, 01.08.2018, p. 1810-1818.

研究成果: 雜誌貢獻文章

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abstract = "The effect of RA on recurrent stroke is unknown. Therefore, we examined effects of rheumatoid arthritis (RA) on risk of stroke recurrence and investigated the interaction between RA and traditional cardiovascular risk factors on recurrence risk after ischemic stroke (IS) or transient ischemic attack (TIA). Of 3190 patients with IS or TIA recruited in this cohort study, 638 were comorbid with RA and 2552 without RA. Stroke recurrence, RA, lifestyle, lipid variables and other comorbidities were identified through linkage between a nationwide stroke database in Taiwan and the National Health Insurance claims database. Cox proportional hazard models with competing risk adjustment were used to evaluate the relationship between RA and recurrent stroke. Patients with RA showed a significantly increased risk of recurrent stroke, particular in recurrent IS/TIA. The increased risk of recurrent IS/TIA in RA patients may through the changes of triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) ratio. A positive additive interaction was observed between RA and current smoking on the risk of recurrent IS/TIA. Significantly increased risks for recurrent IS/TIA were observed among RA patients who smoked > 40 years or those who smoked > 20 cigarettes/day. This study provides the first evidence that RA significantly increased recurrence IS/TIA risk. The changes of TG/HDL-C ratio may play some roles in the recurrence IS/TIA risk in RA patients. In addition, our results suggest that smoking increases the risk of recurrent IS/TIA in RA patients and reinforces the need for aggressive smoking cessation efforts in RA patients.",
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AU - Peng, Giia Sheun

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