Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims Database
ObjectiveEvidences indicate that the risk of stroke is increased in autoimmune rheumatic diseases. This study aimed to investigate the incidence of stroke in patients with systemic necrotizing vasculitis (SNV) using the national health database.MethodsData were obtained from the Korean National Clai...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2021-03-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2021.629902/full |
| _version_ | 1818428391400931328 |
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| author | Sung Soo Ahn Minkyung Han Juyoung Yoo Yong-Beom Park Yong-Beom Park Inkyung Jung Sang-Won Lee Sang-Won Lee |
| author_facet | Sung Soo Ahn Minkyung Han Juyoung Yoo Yong-Beom Park Yong-Beom Park Inkyung Jung Sang-Won Lee Sang-Won Lee |
| author_sort | Sung Soo Ahn |
| collection | DOAJ |
| description | ObjectiveEvidences indicate that the risk of stroke is increased in autoimmune rheumatic diseases. This study aimed to investigate the incidence of stroke in patients with systemic necrotizing vasculitis (SNV) using the national health database.MethodsData were obtained from the Korean National Claims database between 2010 and 2018 to identify incident SNV [anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) and polyarteritis nodosa (PAN)] cases. The standardized incidence ratio (SIR) and incidence rate ratio (IRR) were calculated to estimate the risk of stroke in patients with SNV compared to the general population and among disease subgroups. Time-dependent Cox’s regression analysis was performed to identify risk factors for stroke.ResultsAmong 2644 incident SNV cases, 159 patients (6.0%) were affected by stroke. The overall risk of stroke was significantly higher in patients with SNV compared to the general population (SIR 8.42). Stroke event rates were the highest within the first year of SNV diagnosis (67.3%). Among disease subgroups, patients with microscopic polyangiitis (MPA) exhibited higher IRR compared to PAN (adjusted IRR 1.98). In Cox’s hazard analysis, older age and MPA were associated with higher risk of stroke [hazard ratio (HR) 1.05 and 1.88], whereas the administration of cyclophosphamide, azathioprine/mizoribine, methotrexate, and statins were protective in stroke (HR 0.26, 0.34, 0.49, and 0.50, respectively).ConclusionA considerable number of SNV patients experienced stroke, especially in the early phase of disease. Older age and MPA diagnosis were associated with elevated risk of stroke, while the administration of immunosuppressive agents and statins was beneficial in preventing stroke. |
| first_indexed | 2024-12-14T15:00:53Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1664-3224 |
| language | English |
| last_indexed | 2024-12-14T15:00:53Z |
| publishDate | 2021-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Immunology |
| spelling | doaj.art-0d799624133a48cda76469fc2359b3802022-12-21T22:56:50ZengFrontiers Media S.A.Frontiers in Immunology1664-32242021-03-011210.3389/fimmu.2021.629902629902Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims DatabaseSung Soo Ahn0Minkyung Han1Juyoung Yoo2Yong-Beom Park3Yong-Beom Park4Inkyung Jung5Sang-Won Lee6Sang-Won Lee7Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South KoreaBiostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South KoreaDivision of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South KoreaDivision of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South KoreaInstitute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South KoreaDivision of Biostatistics, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South KoreaDivision of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South KoreaInstitute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, South KoreaObjectiveEvidences indicate that the risk of stroke is increased in autoimmune rheumatic diseases. This study aimed to investigate the incidence of stroke in patients with systemic necrotizing vasculitis (SNV) using the national health database.MethodsData were obtained from the Korean National Claims database between 2010 and 2018 to identify incident SNV [anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) and polyarteritis nodosa (PAN)] cases. The standardized incidence ratio (SIR) and incidence rate ratio (IRR) were calculated to estimate the risk of stroke in patients with SNV compared to the general population and among disease subgroups. Time-dependent Cox’s regression analysis was performed to identify risk factors for stroke.ResultsAmong 2644 incident SNV cases, 159 patients (6.0%) were affected by stroke. The overall risk of stroke was significantly higher in patients with SNV compared to the general population (SIR 8.42). Stroke event rates were the highest within the first year of SNV diagnosis (67.3%). Among disease subgroups, patients with microscopic polyangiitis (MPA) exhibited higher IRR compared to PAN (adjusted IRR 1.98). In Cox’s hazard analysis, older age and MPA were associated with higher risk of stroke [hazard ratio (HR) 1.05 and 1.88], whereas the administration of cyclophosphamide, azathioprine/mizoribine, methotrexate, and statins were protective in stroke (HR 0.26, 0.34, 0.49, and 0.50, respectively).ConclusionA considerable number of SNV patients experienced stroke, especially in the early phase of disease. Older age and MPA diagnosis were associated with elevated risk of stroke, while the administration of immunosuppressive agents and statins was beneficial in preventing stroke.https://www.frontiersin.org/articles/10.3389/fimmu.2021.629902/fullsystemic necrotizing vasculitisanti-neutrophil cytoplasmic antibody-associated vasculitispolyarteritis nodosastrokeincidencemicroscopic polyangiitis |
| spellingShingle | Sung Soo Ahn Minkyung Han Juyoung Yoo Yong-Beom Park Yong-Beom Park Inkyung Jung Sang-Won Lee Sang-Won Lee Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims Database Frontiers in Immunology systemic necrotizing vasculitis anti-neutrophil cytoplasmic antibody-associated vasculitis polyarteritis nodosa stroke incidence microscopic polyangiitis |
| title | Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims Database |
| title_full | Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims Database |
| title_fullStr | Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims Database |
| title_full_unstemmed | Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims Database |
| title_short | Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the National Claims Database |
| title_sort | risk of stroke in systemic necrotizing vasculitis a nationwide study using the national claims database |
| topic | systemic necrotizing vasculitis anti-neutrophil cytoplasmic antibody-associated vasculitis polyarteritis nodosa stroke incidence microscopic polyangiitis |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2021.629902/full |
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