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Abstract Number: 2359

Severity of Ischemic and Hemorrhagic Stroke in Patients with Rheumatoid Arthritis Compared with the General Population

Mei-Yun Hsieh1, Chang-Fu Kuo2, Kuang-Hui Yu2, Shue-Fen Luo2,3 and Yen-Fu Chen2, 1Center for Big Data Analytics and Statistics, Chang Gung Memorial Hospital, Taoyuan, Taiwan, 2Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, 3Chang Gung Memorial Hospital, Taoyuan, Taiwan

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: Cerebrovascular disease, rheumatoid arthritis (RA) and risk assessment

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Session Information

Date: Tuesday, November 7, 2017

Title: Rheumatoid Arthritis – Clinical Aspects Poster III: Comorbidities

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

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.


Disclosure: M. Y. Hsieh, None; C. F. Kuo, None; K. H. Yu, None; S. F. Luo, None; Y. F. Chen, None.

To cite this abstract in AMA style:

Hsieh MY, Kuo CF, Yu KH, Luo SF, Chen YF. Severity of Ischemic and Hemorrhagic Stroke in Patients with Rheumatoid Arthritis Compared with the General Population [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/severity-of-ischemic-and-hemorrhagic-stroke-in-patients-with-rheumatoid-arthritis-compared-with-the-general-population/. Accessed .
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