Rheumatoid arthritis significantly increased recurrence risk after ischemic stroke/transient ischemic attack
| العنوان: | Rheumatoid arthritis significantly increased recurrence risk after ischemic stroke/transient ischemic attack |
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| المؤلفون: | Sung-Chun Tang, Jiann-Shing Jeng, Li Ming Lien, Yueh Feng Sung, Fang I. Hsieh, Giia Sheun Peng, Hung Yi Chiou, Nai Fang Chi, Yih Ru Chen, Chaur Jong Hu |
| المصدر: | Journal of Neurology. 265:1810-1818 |
| بيانات النشر: | Springer Science and Business Media LLC, 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Neurology, Taiwan, Pilot Projects, Comorbidity, 030204 cardiovascular system & hematology, Brain Ischemia, Arthritis, Rheumatoid, Cohort Studies, Brain ischemia, 03 medical and health sciences, 0302 clinical medicine, Recurrence, Risk Factors, Internal medicine, Humans, Medicine, cardiovascular diseases, Stroke, Aged, Proportional Hazards Models, business.industry, Proportional hazards model, Incidence, Incidence (epidemiology), Smoking, medicine.disease, Rheumatoid arthritis, Female, Neurology (clinical), business, 030217 neurology & neurosurgery, Cohort study |
| الوصف: | 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. |
| تدمد: | 1432-1459 0340-5354 |
| DOI: | 10.1007/s00415-018-8885-9 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::cc74141c643ae328cec8b168bb013bdf https://doi.org/10.1007/s00415-018-8885-9 |
| Rights: | CLOSED |
| رقم الانضمام: | edsair.doi.dedup.....cc74141c643ae328cec8b168bb013bdf |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14321459 03405354 |
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| DOI: | 10.1007/s00415-018-8885-9 |