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Stroke in systemic lupus erythematosus: a meta-analysis of population-based cohort studies
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
2015 (English)In: RMD Open, E-ISSN 2056-5933, Vol. 1, no 1, article id UNSP e000168Article, review/survey (Refereed) Published
Abstract [en]

Previous studies of stroke in systemic lupus erythematosus (SLE) have had limited statistical power, combined stroke subtypes into composite outcomes, and lacked a reference population estimate. Therefore, we conducted a systematic review and meta-analysis of cohort studies to summarise the stroke subtype-specific risk in patients with SLE compared to the general population. A systematic search of MEDLINE and EMBASE was performed for cohort studies examining the risk of stroke in SLE and including a general population comparator. Random effects models were used to pool the risk ratio (RR) for stroke. Subgroup analyses were carried out to investigate potential sources of heterogeneity. 10 studies were included which reported RRs for overall stroke (n=5), ischaemic stroke (n=6), intracerebral haemorrhage (n=3) and subarachnoid haemorrhage (n=3). The pooled RR for overall stroke was 2.53 (95% CI 1.96 to 3.26), ischaemic stroke 2.10 (95% CI 1.68 to 2.62), intracerebral haemorrhage 2.72 (95% CI 2.15 to 3.44) and subarachnoid haemorrhage 3.85 (95% CI 3.20 to 4.64). Significant heterogeneity among studies for ischaemic stroke was detected (p=0.002). Relative risk of stroke was highest among individuals younger than 50 years of age. Individuals with SLE have a twofold higher risk of ischaemic stroke, a threefold higher risk of intracerebral haemorrhage, and an almost fourfold higher risk of subarachnoid haemorrhage compared to the general population. Future studies should focus on whether comorbidity and disease flares are related to stroke, when individuals are at the highest risk, and how the targeting of specific groups of patients with SLE may reduce this risk.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2015. Vol. 1, no 1, article id UNSP e000168
National Category
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-153862DOI: 10.1136/rmdopen-2015-000168ISI: 000443516700019PubMedID: 26719816OAI: oai:DiVA.org:umu-153862DiVA, id: diva2:1268324
Available from: 2018-12-05 Created: 2018-12-05 Last updated: 2018-12-05Bibliographically approved

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Asplund, Kjell

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