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Inflammatory bowel diseases increase future ischemic stroke risk: a Taiwanese population-based retrospective cohort study.
Eur J Intern Med. 2014 Jul; 25(6):561-5.EJ

Abstract

BACKGROUND AND AIMS

This cohort study assessed the association between inflammatory bowel disease (IBD) and the risk of future ischemic stroke.

METHODS

The IBD cohort comprised adult patients (≥ 20years old) who had received either ambulatory or inpatient care between 1998 and 2011 and IBD-free controls were randomly selected from the general population and frequency matched according to age, sex, and index year (included 18,392 patients with IBD and 73,568 control patients). Both cohorts with ischemic stroke before the index date and the ischemic stroke cases diagnosed within one year after the index date were excluded. We observed the study patients until the incidence of ischemic stroke, death, withdrawal from the insurance program, or they were lost to follow-up, or the end of 2011.

RESULTS

The risk of ischemic stroke was 1.12-fold (95% CI, 1.02-1.23) higher among the IBD cohort than among the non-IBD cohort. Compared to the subjects without IBD, the adjusted HR of ischemic stroke was 1.15 (95% CI 1.04-1.28) in the Crohn's disease (CD) patients and 1.01 (95% CI 0.84-1.21) in the ulcerative colitis (UC) group. The risk of developing ischemic stroke significantly increased with the increased frequency of IBD exacerbation and hospitalization. Furthermore, the adjusted HR among the CD patients increased in conjunction with the number of medical visits, from 1.07 to 6.36 and the adjusted HR among the UC patients also increased in conjunction with the number of medical visits, from 1.11 to 2.10.

CONCLUSIONS

IBD exhibited an increased risk of developing ischemic stroke.

Authors+Show Affiliations

Department of Neurology, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.Department of Neurology, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan; Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan.Department of Neurology, China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan.Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Department of Public Health, China Medical University, Taichung, Taiwan. Electronic address: fcsung@mail.cmu.edu.tw.Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24906568

Citation

Huang, Wei-Shih, et al. "Inflammatory Bowel Diseases Increase Future Ischemic Stroke Risk: a Taiwanese Population-based Retrospective Cohort Study." European Journal of Internal Medicine, vol. 25, no. 6, 2014, pp. 561-5.
Huang WS, Tseng CH, Chen PC, et al. Inflammatory bowel diseases increase future ischemic stroke risk: a Taiwanese population-based retrospective cohort study. Eur J Intern Med. 2014;25(6):561-5.
Huang, W. S., Tseng, C. H., Chen, P. C., Tsai, C. H., Lin, C. L., Sung, F. C., & Kao, C. H. (2014). Inflammatory bowel diseases increase future ischemic stroke risk: a Taiwanese population-based retrospective cohort study. European Journal of Internal Medicine, 25(6), 561-5. https://doi.org/10.1016/j.ejim.2014.05.009
Huang WS, et al. Inflammatory Bowel Diseases Increase Future Ischemic Stroke Risk: a Taiwanese Population-based Retrospective Cohort Study. Eur J Intern Med. 2014;25(6):561-5. PubMed PMID: 24906568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Inflammatory bowel diseases increase future ischemic stroke risk: a Taiwanese population-based retrospective cohort study. AU - Huang,Wei-Shih, AU - Tseng,Chun-Hung, AU - Chen,Pei-Chun, AU - Tsai,Chon-Haw, AU - Lin,Cheng-Li, AU - Sung,Fung-Chang, AU - Kao,Chia-Hung, Y1 - 2014/06/03/ PY - 2014/03/05/received PY - 2014/05/12/revised PY - 2014/05/15/accepted PY - 2014/6/8/entrez PY - 2014/6/8/pubmed PY - 2015/2/20/medline KW - Crohn's disease KW - Inflammatory bowel disease KW - Ischemic stroke KW - National Health Insurance Research Database KW - Nationwide population-based cohort study KW - Ulcerative colitis SP - 561 EP - 5 JF - European journal of internal medicine JO - Eur J Intern Med VL - 25 IS - 6 N2 - BACKGROUND AND AIMS: This cohort study assessed the association between inflammatory bowel disease (IBD) and the risk of future ischemic stroke. METHODS: The IBD cohort comprised adult patients (≥ 20years old) who had received either ambulatory or inpatient care between 1998 and 2011 and IBD-free controls were randomly selected from the general population and frequency matched according to age, sex, and index year (included 18,392 patients with IBD and 73,568 control patients). Both cohorts with ischemic stroke before the index date and the ischemic stroke cases diagnosed within one year after the index date were excluded. We observed the study patients until the incidence of ischemic stroke, death, withdrawal from the insurance program, or they were lost to follow-up, or the end of 2011. RESULTS: The risk of ischemic stroke was 1.12-fold (95% CI, 1.02-1.23) higher among the IBD cohort than among the non-IBD cohort. Compared to the subjects without IBD, the adjusted HR of ischemic stroke was 1.15 (95% CI 1.04-1.28) in the Crohn's disease (CD) patients and 1.01 (95% CI 0.84-1.21) in the ulcerative colitis (UC) group. The risk of developing ischemic stroke significantly increased with the increased frequency of IBD exacerbation and hospitalization. Furthermore, the adjusted HR among the CD patients increased in conjunction with the number of medical visits, from 1.07 to 6.36 and the adjusted HR among the UC patients also increased in conjunction with the number of medical visits, from 1.11 to 2.10. CONCLUSIONS: IBD exhibited an increased risk of developing ischemic stroke. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/24906568/Inflammatory_bowel_diseases_increase_future_ischemic_stroke_risk:_a_Taiwanese_population_based_retrospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(14)00145-9 DB - PRIME DP - Unbound Medicine ER -