Parkinson's disease is related to an increased risk of ischemic stroke-a population-based propensity score-matched follow-up study

Ya-Ping Huang, Li-Sheng Chen, Ming-Fang Yen, Ching-Yuan Fann, Yueh-Hsia Chiu, Hsiu-Hsi Chen, Shin-Liang Pan

Research output: Contribution to journalArticlepeer-review

300 Citations (Scopus)


OBJECTIVE: The risk of stroke in patients with Parkinson's disease (PD) remains controversial. The purpose of this population-based propensity score-matched longitudinal follow-up study was to determine whether there is an increased risk of ischemic stroke after PD.

METHODS: We used a logistic regression model that includes age, sex, pre-existing comorbidities and socioeconomic status as covariates to compute the propensity score. A total of 2204 patients with at least two ambulatory visits with the principal diagnosis of PD in 2001 was enrolled in the PD group. The non- PD group consisted of 2204, propensity score-matched subjects without PD. The ischemic stroke-free survival rates of the two groups were estimated using the Kaplan-Meier method. Stratified Cox proportional hazard regression with patients matched on propensity score was used to estimate the effect of PD on the occurrence of ischemic stroke.

RESULTS: During the three-year follow-up period, 328 subjects in the PD group and 156 subjects in the non-PD group developed ischemic stroke. The ischemic stroke-free survival rate of the PD group was significantly lower than that of the non-PD group (P<0.0001). The hazard ratio (HR) of stroke for the PD group was 2.37 (95% confidence interval [CI], 1.92 to 2.93, P<0.0001) compared to the non- PD group.

CONCLUSIONS: This study shows a significantly increased risk of ischemic stroke in PD patients. Further studies are required to investigate the underlying mechanism.

Original languageEnglish
Pages (from-to)e68314
JournalPLoS One
Issue number9
Publication statusPublished - 2013


  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Parkinson Disease
  • Propensity Score
  • Prospective Studies
  • Stroke
  • Journal Article
  • Research Support, Non-U.S. Gov't


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