The risk of ischemic stroke in patients with idiopathic inflammatory myopathies: a systematic review and meta-analysis
- 1 May 2021
- journal article
- review article
- Published by Springer Science and Business Media LLC in Clinical Rheumatology
- Vol. 40 (10), 4101-4108
- https://doi.org/10.1007/s10067-021-05751-2
Abstract
Objective Idiopathic inflammatory myopathies (IIM) are a group of chronic rheumatic diseases that can affect multiple systems; the risk of ischemic stroke in patients with IIM remains controversial. We aimed to systematically evaluate the risk of ischemic stroke in IIMs. Methods The PubMed, Embase, and Cochrane library were searched for relevant studies. Pooled relative risk (RR) with a 95% confidence interval (CI) was calculated as effect size to evaluate the risk of ischemic stroke in patients with IIM. Random effects model was chosen when I2 > 50%. We pooled all studies in a first total analysis to assess the risk of ischemic stroke in IIM. Subgroup analyses were conducted based on the subtypes of IIM (dermatomyositis) and country. Sensitivity analysis was performed to identify the heterogeneity sources. Results A total of 6 studies with 5,114 IIM cases and 14,516,099 controls were included, and the results demonstrated that IIMs were associated with an increased risk of ischemic stroke (RR = 2.41, 95% CI: 1.31, 4.45). Subgroup analysis indicated that patients with dermatomyositis (DM) had a 49% excess risk of ischemic stroke than controls; Asian patients with IIM had an increased risk of ischemic stroke, although not for American patients. Conclusion IIMs, especially patients with DM, are associated with an increased risk of ischemic stroke. Appropriate intervention may be taken into account for patients with IIM, especially when accompanied by other traditional risk factors of ischemic stroke. Key Points • This study evaluated the risk of ischemic stroke in patients with IIMs. • Generally, IIMs are associated with an increased risk of ischemic stroke. • Patients with DM had a 49% excess risk of ischemic stroke than controls. • Subgroup analysis showed that Asian patients with IIMs were at increased risk of ischemic stroke, but not Americans.This publication has 29 references indexed in Scilit:
- AtherosclerosisNature Reviews Disease Primers, 2019
- The Risk of Ischemic and Hemorrhagic Stroke in Patients With Idiopathic Inflammatory Myopathies: A Swedish Population‐Based Cohort StudyArthritis Care & Research, 2019
- Classification and management of adult inflammatory myopathiesThe Lancet Neurology, 2018
- Health care costs and comorbidities for patients with inclusion body myositisCurrent Medical Research and Opinion, 2018
- Cardiovascular and cerebrovascular comorbidities of juvenile dermatomyositis in US children: an analysis of the National Inpatient SampleRheumatology, 2018
- Risk of myocardial infarction and ischaemic stroke in adults with polymyositis and dermatomyositis: a general population-based studyRheumatology, 2015
- Cancer Risk in Dermatomyositis: A Meta-Analysis of Cohort StudiesAmerican Journal of Clinical Dermatology, 2015
- Dermatomyositis is associated with an increased risk of cardiovascular and cerebrovascular events: a Taiwanese population-based longitudinal follow-up studyBritish Journal of Dermatology, 2013
- Morbidity and Mortality in Adult Polymyositis and DermatomyositisCurrent Rheumatology Reports, 2012
- Autoimmune myopathies: autoantibodies, phenotypes and pathogenesisNature Reviews Neurology, 2011