Systemic sclerosis and risk of ischaemic stroke: A nationwide cohort study

Chia Hung Chiang, Chia Jen Liu, Chin Chou Huang, Wan Leong Chan, Po Hsun Huang, Tzeng Ji Chen, Chia Min Chung, Shing Jong Lin, Jaw Wen Chen, Hsin Bang Leu

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)


Objective. To investigate whether SSc increases the risk of ischaemic stroke in a large, nationwide cohort study.Methods. From the Registry of Catastrophic Illness in Taiwan, we obtained data for 1280 patients with a diagnosis of SSc from 1997 to 2006. We also obtained data for 10 age-, gender-, comorbidity- and enrolment date-matched controls per SSc patient from the Longitudinal Health Insurance 2000. All study subjects were followed up from the date of enrolment until they developed ischaemic stroke, death or to the end of 2006, whichever was earlier. We used Cox's regression model with adjustment for age, gender and comorbid disorders to assess the independent factors in determining the risk of developing ischaemic stroke.Results. We identified 1238 SSc patients and 12 380 controls. Among these patients, 765 (86 SSc patients and 679 controls) had developed ischaemic stroke during the median 4.7 years (0.1-10.0 years) of follow-up. Patients with SSc had a significantly higher incidence of ischaemic stroke when compared with controls (16.5/1000 vs 11.5/1000 person-year). After multivariate analysis, SSc was associated with a 43% increase in ischaemic stroke risk (95% CI 12%, 83%; P = 0.004). Additionally, the medication usually being prescribed among SSc patients did not alter the risk of further ischaemic stroke.Conclusion. We conclude that SSc is independently associated with higher risk of ischaemic stroke development.

Original languageEnglish
Article numberkes352
Pages (from-to)161-165
Number of pages5
JournalRheumatology (United Kingdom)
Issue number1
Publication statusPublished - Jan 2013
Externally publishedYes


  • Atherosclerosis
  • Ischaemic stroke
  • Systemic sclerosis

ASJC Scopus subject areas

  • Rheumatology
  • Pharmacology (medical)


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