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

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A Correction to this article was published on 24 March 2018

This article has been updated

Abstract

Background

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).

Methods

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.

Results

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.

Conclusion

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

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  • 24 March 2018

    The authors regret to state that an incorrect image was uploaded in Fig. 2. Please see a newly updated Fig. 2. All statements including Figure Legends are correct.

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Funding

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).

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Authors and Affiliations

  1. Department of Neurosurgery, CHA Bundang Medical Center, CHA University College of Medicine, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, South Korea

    Dong Hyun Lee, In-bo Han, Je Beom Hong & Seil Sohn

  2. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, South Korea

    Yoon Jin Choi

  3. Department of Biostatistics, College of Medicine, Catholic University of Korea, Seoul, South Korea

    Kyung Do Han

  4. Department of Medical Device Management and Research, SAIHST, Sungkyunkwan University, Seoul, South Korea

    Jung Min Choi

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  1. Dong Hyun Lee
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Correspondence to Seil Sohn.

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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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Lee, D.H., Choi, Y.J., Han, Ib. et al. Association of ischemic stroke with ankylosing spondylitis: a nationwide longitudinal cohort study. Acta Neurochir 160, 949–955 (2018). https://doi.org/10.1007/s00701-018-3499-7

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  • DOI: https://doi.org/10.1007/s00701-018-3499-7

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