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Risk of Stroke in 28,000 Patients with Celiac Disease: A Nationwide Cohort Study in Sweden
Department of Pediatrics, Örebro University Hospital, Örebro, Sweden; Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.ORCID iD: 0000-0003-1024-5602
Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Nottinghamshire, United Kingdom.ORCID iD: 0000-0002-1135-9356
Division of Epidemiology and Public Health, University of Nottingham, Nottingham City Hospital, Nottinghamshire, United Kingdom; Department of Gastroenterology, Kings Mill Hospital, Sutton in Ashfield, Nottinghamshire, United Kingdom.ORCID iD: 0000-0003-2555-2250
Department of Neurology, Örebro University Hospital, Örebro, Sweden.
2012 (English)In: Journal of Stroke & Cerebrovascular Diseases, ISSN 1052-3057, E-ISSN 1532-8511, Vol. 21, no 8, 860-867 p.Article in journal (Refereed) Published
Abstract [en]

Background: Earlier studies on stroke in celiac disease (CD) have been underpowered, but a recent study suggested that childhood CD is associated with a 10-fold increased risk of death from stroke, although it was based on small numbers. We examined the risk of stroke in patients with biopsy-verified CD.

Methods: We collected biopsy data from all 28 pathology departments in Sweden and identified 28,676 individuals with CD diagnosed between 1969 and 2007 (Marsh 3: villous atrophy). In the main analyses, we used Cox regression to estimate hazard ratios (HRs) for stroke in patients with CD compared with HRs for stroke in 141,806 sex-and age-matched controls.

Results: During follow-up, there were 785 first-stroke diagnoses in patients with CD and 2937 in reference individuals. Patients with CD were at increased risk of stroke (HR 1.10; 95% confidence interval [CI] 1.01-1.19). HRs were similar for ischemic stroke and brain hemorrhage and were not affected by adjustment for type 1 diabetes, rheumatoid arthritis, use of medication against hypertension, or dyslipidemia. The absolute risk of stroke in patients with CD was 267 per 100,000 person-years (excess risk 24/100,000). The highest risk estimates occurred in the first year, with virtually no increased risk after more than 5 years of follow-up after CD diagnosis. The HR for stroke in childhood CD was 1.10 (95% CI 0.37-3.22).

Conclusions: Patients with CD are at only a small increased risk of stroke, which persists only for a brief period after diagnosis. CD does not seem to be a major risk factor for stroke.

Place, publisher, year, edition, pages
Elsevier, 2012. Vol. 21, no 8, 860-867 p.
Keyword [en]
Autoimmunity, celiac, inflammation, stroke
National Category
Neurology Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-55682DOI: 10.1016/j.jstrokecerebrovasdis.2011.05.008ISI: 000310641900038PubMedID: 21733721Scopus ID: 2-s2.0-84868362788OAI: oai:DiVA.org:oru-55682DiVA: diva2:1074079
Funder
Swedish Society of Medicine
Note

Funding Agencies:

Örebro University Hospital

Swedish Research Council-Medicine 522-2A09-195

Sven Jerring Foundation

Örebro Society of Medicine

Karolinska Institutet

Clas Groschinsky Foundation

Juhlin Foundation

Majblomman Foundation

Uppsala-Örebro Regional Research Council

Swedish Celiac Society

UK National Institute for Health Research Clinician Scientist Fellowship

Research Ethics Committee of the Karolinska Institute, Sweden 2006/633-31/4

Available from: 2017-02-14 Created: 2017-02-14 Last updated: 2017-03-27Bibliographically approved

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CiteExportLink to record
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