Background/Purpose:

Rheumatoid arthritis (RA) patients are at higher risk of developing stroke but whether their risks for severe strokes are unknown.

Methods:

All patients with a diagnosis of RA who were registered in The National Health Insurance Research Database (NHIRD) of Taiwan from 1999 through 2005 were identified (N=23,820), and each patient was matched with one controls by age and gender. All those hospitalized for a first Ischemic stroke or hemorrhagic stroke were identified between the date of diagnosis of RA and December 31,2015 or death. We used a claims-based stroke severity index (SSI) in patients with stroke to evaluate the risk in different severity (severe form: SSI > 12). Hazard ratios (HRs) and 95% confidence intervals (95% CI) were estimated using Cox proportional hazard regression models after adjusting for age, sex, Charlson comorbidity index (CCI) and co-medication.

Results:

We observed 1179 (4.95%) ischemic strokes and 14 (3.42%) hemorrhagic strokes in RA patients, compared to 1166 (4.90%) and 659 (2.77%) in the matched controls. The crude incidence rates (95% CI) of ischemic strokes and hemorrhagic strokes per 100 person years among 23,820 RA patients were 6.0 (5.6­-6.3) and 4.1(3.9­-4.4), respectively, compared to 5.85 (5.53-6.20) and 3.25(3.01-3.50) in matched controls. Multivariate HR (95% CI) were 1.09 (0.98-1.22) for ischemic stroke and 1.38(1.21-1.58) for hemorrhagic stroke. The HR (95% CI) was 1.05(0.93-1.19) for mild Ischemic stroke, 1.21 (0.98-1.49) for severe ischemic stroke, 1.25 (1.04-1.50) for mild Hemorrhagic stroke and 1.53 (1.26-1.86) for severe hemorrhagic stroke.

Conclusion:

RA patients have higher risks for severe strokes, particularly for hemorrhagic form.

« Back to 2017 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/severity-of-ischemic-and-hemorrhagic-stroke-in-patients-with-rheumatoid-arthritis-compared-with-the-general-population/