Acta Neurochirurgica

, Volume 160, Issue 5, pp 949–955 | Cite as

Association of ischemic stroke with ankylosing spondylitis: a nationwide longitudinal cohort study

  • Dong Hyun Lee
  • Yoon Jin Choi
  • In-bo Han
  • Je Beom Hong
  • Kyung Do Han
  • Jung Min Choi
  • Seil SohnEmail author
Original Article - Spine



The purpose of this nationwide age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in ankylosing spondylitis (AS).


The data in this study, spanning from January 1, 2010 to December 31, 2014, was obtained from a database maintained by the Korean National Health Insurance Service. A total of 12,988 patients with a diagnosis of AS were enrolled. The control group consisted of 64,940 age-sex-stratified matching subjects without AS. The 6year ischemic stroke incidence rate for each group was calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke.


During the follow-up period, 73 patients (0.56%) in the AS group and 250 patients (0.38%) in the control group developed ischemic stroke (p = 0.0041). The hazard ratio of ischemic stroke in the AS group was 1.46 (95% confidence interval [95% CI], 1.13–1.90) after adjusting for age and sex. The adjusted hazard ratio of ischemic stroke in the AS group was 1.35 (95% CI, 1.04–1.75) after controlling for demographics and comorbid medical disorders. According to subgroup analysis, in female and diabetes and non-hypertension and dyslipidemia subgroups, ischemic stroke incidence rates were significantly higher in AS patients than those in control group.


Our nationwide longitudinal study suggests an increased risk of ischemic stroke in AS patients.


Ankylosing spondylitis Stroke Population Epidemiology 



This work was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03032980). This work was also supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (HR16C0002).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

The need for informed consent was waived because the data used consisted of de-identified secondary data released for research purposes and were analyzed anonymously.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Neurosurgery, CHA Bundang Medical CenterCHA University College of MedicineSeongnam-siSouth Korea
  2. 2.Department of Internal MedicineSeoul National University Bundang HospitalSeongnamSouth Korea
  3. 3.Department of Biostatistics, College of MedicineCatholic University of KoreaSeoulSouth Korea
  4. 4.Department of Medical Device Management and Research, SAIHSTSungkyunkwan UniversitySeoulSouth Korea

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