Risk of ischemic stroke in patients with systemic sclerosis: A systematic review and meta-analysis

Abstract

Background. Several chronic inflammatory disorders, such as rheumatoid arthritis and idiopathic inflammatory myositis, have been shown to increase risk of ischemic stroke but the data on systemic sclerosis (SSc) remains unclear.

Methods. We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing risk of ischemic stroke in patients with SSc versus non-SSc participants. Pooled risk ratio and 95% confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird.

Results. Four retrospective cohort studies were identified and included in our data analysis. We found a statistically significant elevated ischemic stroke risk in patients with SSc with a pooled risk ratio of 1.68 (95% CI, 1.26–2.24). The statistical heterogeneity was moderate with an I² of 69%.

Conclusions. Our study demonstrated a statistically significant increased ischemic stroke risk among patients with SSc.

Keywords:

• Epidemiology
• Inflammation
• Meta-analysis
• Stroke
• Systemic sclerosis

Authors’ contributions

All authors had access to the data and a role in writing the manuscript.

P. Ungprasert: Concept and design, performing the search, analysis, and interpretation of data, critical writing of the intellectual content, and final approval of the version to be published.

A. Sanguankeo: Performing the search, analysis, and interpretation of data, critical writing of the intellectual content, and final approval of the version to be published.

S. Upala: Analysis of data, critical revising of the intellectual content, and final approval of the version to be published.

Funding

None.

Conflict of interest

None.

Supplementary material available online

Supplementary Questionnaire.