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Stroke in systemic lupus erythematosus: a Swedish population-based cohort study
Karolinska Institute, Sweden.
Karolinska Institute, Sweden.
Karolinska Institute, Sweden.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Hjärt- och Medicincentrum, Reumatologiska kliniken i Östergötland.
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2017 (Engelska)Ingår i: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, nr 9, s. 1544-1549Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective To study the occurrence of ischaemic and haemorrhagic stroke in systemic lupus erythematosus (SLE) compared with the general population by age, sex and time since SLE diagnosis Methods Adults with incident SLE were identified from the Swedish National Patient Register (NPR, n=3390) and general population comparators from the Total Population Register were matched on age, sex and county (n=16730). Individuals were followed prospectively until first of death, December 2013, emigration or incident stroke (identified from the NPR, Cause of Death Register and the Stroke Register). Incidence rates, rate differences and HR were estimated comparing SLE with non-SLE. Estimates were stratified by sex, age and time since diagnosis. Results We observed 126 strokes in SLE and 304 in the general population. Individuals with SLE had a twofold increased rate of ischaemic stroke compared with the general population (HR 2.2; 95% CI 1.7 to 2.8). The HR for intracerebral haemorrhage was 1.4 (95% CI 0.7 to 2.8). There was effect modification by sex and age, with the highest HRs for females and individuals amp;lt;50 years old. The HR for ischaemic stroke was highest in the first year of follow-up (3.7; 95% CI 2.1 to 6.5). Conclusions The relative risk of ischaemic stroke in SLE was more than doubled compared with the general population, and importantly, the highest relative risks were observed within the first year after SLE diagnosis. Thus, the first encounter with patients presents an opportunity for rheumatologists to screen for risk factors and intervene.

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BMJ PUBLISHING GROUP , 2017. Vol. 76, nr 9, s. 1544-1549
Nationell ämneskategori
Reumatologi och inflammation
Identifikatorer
URN: urn:nbn:se:liu:diva-140790DOI: 10.1136/annrheumdis-2016-210973ISI: 000407833100024PubMedID: 28400384OAI: oai:DiVA.org:liu-140790DiVA, id: diva2:1140502
Anmärkning

Funding Agencies|STROKE-Riksforbundet (The Swedish Stroke Association); County Council of Ostergotland; Swedish Heart-Lung foundation; Swedish Rheumatism Association; Swedish Society of Medicine; King Gustaf V 80-year foundation; Swedish Research Council; Stockholm County Council (ALF project)

Tillgänglig från: 2017-09-12 Skapad: 2017-09-12 Senast uppdaterad: 2017-10-05

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Sjöwall, Christopher
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Avdelningen för neuro- och inflammationsvetenskapMedicinska fakultetenReumatologiska kliniken i Östergötland
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