건강보험 청구자료를 이용한 한국인 염증성 관절염 환자의 뇌졸중 발생 분석

• 영문명: Acute Ischemic Stroke in the Patients with Inflammatory Arthritis: An Analysis of Data from National Health Insurance Service
• 발행기관: 대한임상노인의학회
• 저자명: 이기정 최정규 박진수 표정윤 한민경 이준홍
• 간행물 정보: 『대한임상노인의학회지』제23권 제2호, 96~114쪽, 전체 19쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2022.12.31

영문 초록

Background: Inflammation is an important mechanism in stroke. To a considerable extent, the pathophysiology of inflammatory arthritis is influenced by inflammatory cells and cytokines. We compared the risk of stroke between patients with inflammatory arthritis and matched controls, using data from the National Health Insurance Service. Methods: Using a combination of primary diagnosis and V codes for rare incurable diseases, we defined the patients with ankylosing spondylitis, seropositive rheumatoid arthritis, and psoriatic arthritis and enteropathic spondyloarthropathy. The control group was defined by 1:5 propensity score-matching for each disease. Newly developed stroke was identified in the patients with the primary diagnosis of (I60-64) and 1) brain imaging or 2) a prescription of stroke medication or related intervention. Results: The occurrence of stroke was more frequently associated with seropositive rheumatoid arthritis in both the patient population and the seropositive rheumatoid arthritis control group (hazard ratio 1:11, 95% CI 1.02-1.20, P=0.012). In this study, the frequency of stroke occurrence was not associated with the diagnosis of ankylosing spondylitis nor psoriatic arthritis or enteropathic spondyloarthropathy. Furthermore, the use of biologic agents was not associated with the occurrence of stroke, using multivariable analyses in the three different types of inflammatory arthritis and their respective control groups. Conclusion: Seropositive rheumatoid arthritis was a predictor of frequent stroke occurrences. The patients with seropositive rheumatoid arthritis must be cautious with regard to the occurrence of a comorbid stroke. Further studies with long-term follow-ups of clinical outcomes are warranted to explain the underlying correlation between inflammatory arthritis and the risk of stroke.

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키워드

Ankylosing spondylitis Inflammatory arthritis Psoriatic arthritis Rheumatoid arthritis Stroke