Table 2.
Summary of the studies exploring the risk of cerebrovascular ischemic disease in IBD.
| Authors | Year of publication | Study design | Results |
|---|---|---|---|
| Chen et al. (74) | 2021 | Meta-analysis | 8 cohort studies and 1 case–control study (including 149,908 patients with stroke) were identified. IBD was associated with an elevated risk of stroke (OR/RR = 1.21, 95% CI: 1.08–1.34). Both CD and UC were associated with a higher risk of stroke (CD: OR/RR = 1.25, 95% CI: 1.03–1.52; UC: OR/RR = 1.09, 95% CI: 1.04–1.15). |
| Xiao et al. (76) | 2015 | Meta-analysis | 8 articles (126,493 IBD patients and 4,748 cases of stroke) were included. IBD had an increased risk of stroke (HR: 1.29; 95% CI: 1.16–1.43). The risk of stroke was higher in younger individuals (HR: 1.48; 95% CI: 1.77–2.85) than in older individuals (HR = 1.35; 95% CI: 1.04–1.77) |
| Yuan et al. (78) | 2015 | Meta-analysis | 8 cohort studies were included. IBD patients experienced an increased risk of stroke when compared with non-IBD (combined RR: 1.32; 95% CI: 1.20–1.44). The pooled estimate of multivariate RRs was 1.23 among men (95% CI: 1.04–1.45), and 1.46 among women (95% CI: 1.12–1.91). |
| Ghoneim et al. (70) | 2020 | Population-based cohort study | 52,176,550 subjects were included, of whom 261,890 with IBD. The prevalence of CVA was higher in individuals with IBD compared to non-IBD patients (6.24% vs. 0.48%, p < 0.0001). After adjusting for conventional risk factors for CVA, the OR of CVA in subjects with IBD remained higher (OR: 8.07, 95% CI: 7.9–8.2). |
| Huang et al. (71) | 2014 | Retrospective cohort study | 18,392 patients with IBD and 73,568 matched non-IBD control patients were included. The risk of IS was 1.12-fold (95% CI: 1.02–1.23) higher among IBD individuals than among non-IBD individuals. |
| Keller et al. (72) | 2015 | Population-based cohort study | A cohort of 3,309 subjects with CD and a comparison cohort of 13,236 matched non-IBD individuals were included. The HR for stroke among the CD cohort was 1.911 (95% CI: 1.65–2.22) compared to the non-IBD cohort. |
| Tanislav et al. (73) | 2021 | Petrospective cohort study | Each cohort (subjects with IBD and non-IBD matched controls) included 11,947 individuals. Stroke and TIA incidences were higher in CD patients than in controls (stroke: HR: 1.50, p = 0.013; TIA: HR: 1.93, p = 0.004). No relevant differences in were found in UC patients. |
| Andersohn et al. (75) | 2010 | Population-based nested case-control study | 8,054 patients with and 161,078 patients without CD were recruited. 1,748 cases of IS were identified to whom 17,348 controls were matched. CD was not associated with an increased risk of IS (OR: 1.10, 95% CI: 0.85–1.43). However, an increase in risk was observed in younger patients (<50 years: OR: 2.93; 95% CI: 1.44–5.98) but not in elderly patients (> or =50 years: OR: 0.99; 95% CI: 0.75–1.30). |
| Kristensen et al. (77) | 2014 | Nationwide cohort study | 24,499 subjects with IBD and 236,275 matched controls were recruited. Increased stroke risk was exclusively found during active IBD (IRRs for flares: 1.57, 95% CI: 1.27–1.93) (IRRs for persistent activity: 1.71, 95% CI: 1.32–2.21) (IRRs for remission: 1.04, 95% CI: 0.93–1.15). |
CD, Crohn's disease; CVA, cerebrovascular accidents; IRRs, incidence rate ratios; IS, ischemic stroke; TIA, transient ischemic attack; RR, relative risk; UC, ulcerative colitis.