PMID- 33868249
OWN - NLM
STAT- MEDLINE
DCOM- 20210920
LR  - 20240331
IS  - 1664-3224 (Electronic)
IS  - 1664-3224 (Linking)
VI  - 12
DP  - 2021
TI  - Risk of Stroke in Systemic Necrotizing Vasculitis: A Nationwide Study Using the 
      National Claims Database.
PG  - 629902
LID - 10.3389/fimmu.2021.629902 [doi]
LID - 629902
AB  - OBJECTIVE: Evidences 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. METHODS: Data 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. RESULTS: Among 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). CONCLUSION: A 
      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.
CI  - Copyright (c) 2021 Ahn, Han, Yoo, Park, Jung and Lee.
FAU - Ahn, Sung Soo
AU  - Ahn SS
AD  - Department of Internal Medicine, Yongin Severance Hospital, Yonsei University 
      College of Medicine, Yongin, South Korea.
FAU - Han, Minkyung
AU  - Han M
AD  - Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, 
      Yonsei University College of Medicine, Seoul, South Korea.
FAU - Yoo, Juyoung
AU  - Yoo J
AD  - Division of Rheumatology, Department of Internal Medicine, Yonsei University 
      College of Medicine, Seoul, South Korea.
FAU - Park, Yong-Beom
AU  - Park YB
AD  - Division of Rheumatology, Department of Internal Medicine, Yonsei University 
      College of Medicine, Seoul, South Korea.
AD  - Institute for Immunology and Immunological Diseases, Yonsei University College of 
      Medicine, Seoul, South Korea.
FAU - Jung, Inkyung
AU  - Jung I
AD  - Division of Biostatistics, Department of Biomedical Systems Informatics, Yonsei 
      University College of Medicine, Seoul, South Korea.
FAU - Lee, Sang-Won
AU  - Lee SW
AD  - Division of Rheumatology, Department of Internal Medicine, Yonsei University 
      College of Medicine, Seoul, South Korea.
AD  - Institute for Immunology and Immunological Diseases, Yonsei University College of 
      Medicine, Seoul, South Korea.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210331
PL  - Switzerland
TA  - Front Immunol
JT  - Frontiers in immunology
JID - 101560960
RN  - Systemic necrotizing angiitis
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications
MH  - Databases, Factual
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Microscopic Polyangiitis/complications
MH  - Middle Aged
MH  - Polyarteritis Nodosa/*complications
MH  - Proportional Hazards Models
MH  - Risk Factors
MH  - Stroke/epidemiology/*etiology
PMC - PMC8046646
OTO - NOTNLM
OT  - anti-neutrophil cytoplasmic antibody-associated vasculitis
OT  - incidence
OT  - microscopic polyangiitis
OT  - polyarteritis nodosa
OT  - stroke
OT  - systemic necrotizing vasculitis
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2021/04/20 06:00
MHDA- 2021/09/21 06:00
PMCR- 2021/01/01
CRDT- 2021/04/19 06:21
PHST- 2020/11/16 00:00 [received]
PHST- 2021/03/16 00:00 [accepted]
PHST- 2021/04/19 06:21 [entrez]
PHST- 2021/04/20 06:00 [pubmed]
PHST- 2021/09/21 06:00 [medline]
PHST- 2021/01/01 00:00 [pmc-release]
AID - 10.3389/fimmu.2021.629902 [doi]
PST - epublish
SO  - Front Immunol. 2021 Mar 31;12:629902. doi: 10.3389/fimmu.2021.629902. eCollection 
      2021.