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Acta Neurochir (Wien). 2018 May;160(5):949-955. doi: 10.1007/s00701-018-3499-7. Epub 2018 Feb 22.

Association of ischemic stroke with ankylosing spondylitis: a nationwide longitudinal cohort study.

Author information

1
Department of Neurosurgery, CHA Bundang Medical Center, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, South Korea.
2
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea.
3
Department of Biostatistics, College of Medicine, Catholic University of Korea, Seoul, South Korea.
4
Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, South Korea.
5
Department of Neurosurgery, CHA Bundang Medical Center, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, South Korea. sisohn@cha.ac.kr.

Abstract

BACKGROUND:

The purpose of this nationwide age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in ankylosing spondylitis (AS).

METHODS:

The data in this study, spanning from January 1, 2010 to December 31, 2014, was obtained from a database maintained by the Korean National Health Insurance Service. A total of 12,988 patients with a diagnosis of AS were enrolled. The control group consisted of 64,940 age-sex-stratified matching subjects without AS. The 6year ischemic stroke incidence rate for each group was calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke.

RESULTS:

During the follow-up period, 73 patients (0.56%) in the AS group and 250 patients (0.38%) in the control group developed ischemic stroke (pā€‰=ā€‰0.0041). The hazard ratio of ischemic stroke in the AS group was 1.46 (95% confidence interval [95% CI], 1.13-1.90) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in the AS group was 1.35 (95% CI, 1.04-1.75) after controlling for demographics and comorbid medical disorders. According to subgroup analysis, in female and diabetes and non-hypertension and dyslipidemia subgroups, ischemic stroke incidence rates were significantly higher in AS patients than those in control group.

CONCLUSION:

Our nationwide longitudinal study suggests an increased risk of ischemic stroke in AS patients.

KEYWORDS:

Ankylosing spondylitis; Epidemiology; Population; Stroke

PMID:
29470721
DOI:
10.1007/s00701-018-3499-7

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