Multiple sclerosis tied to increased risk for stroke

  • Hong Y & al.
  • BMC Neurol
  • 24 Jun 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This meta-analysis suggests that patients with multiple sclerosis (MS) are at an increased risk for developing any type of stroke, particularly ischaemic stroke compared with the general population.

Why this matters

  • MS and stroke are the two most common causes of death and disability worldwide, but the association between these 2 diseases remains unclear.

Study design

  • Meta-analysis of 9 studies involving >380,000 participants identified after a search across MEDLINE, Embase and other databases.
  • Funding: National Key R&D Program of China.

Key results

  • Patients with MS vs those without were at increased risk for any type of stroke during 1 (risk ratio [RR], 3.48; 95% CI, 1.59-7.64; P=.002; I2, 90%) and 10-13 years (RR, 2.45; 95% CI, 1.90-3.16; P<.00001 i>2, 66%) of follow-up.
  • Male veterans with MS had higher prevalence of any type of stroke vs those without MS (RR, 2.00; 95% CI, 1.19-3.38; P=.009; I2, 93%) and the general population (RR, 2.93; 95% CI, 1.13-7.62; P=.03; I2, 98%).
  • After 1-year of follow-up, ischaemic stroke was more common in the patients with MS vs those without (RR, 6.09; 95% CI, 3.44-10.77; P<.00001>
  • In sub-group analysis:
    • The risk for any type of stroke was significantly higher in middle-aged (RR, 2.07; 95% CI, 1.71-2.50) and elderly (RR, 1.94; 95% CI, 1.56-2.42; P<.00001 patients with ms vs those without.>
    • Men (RR, 2.20; 95% CI, 1.72-2.80; I2, 84%) and women (RR, 2.09; 95% CI, 1.75-2.50; I2, 69%) with MS were at increased risk for any type of stroke vs those without.

Limitations

  • Heterogeneity among studies.
  • Independent analyses of lifestyle factors, social status, education, and other factors were not performed.