TY - JOUR
T1 - Increased risk for stroke in patients with familial Mediterranean fever
T2 - results from a large population-based study
AU - Ben-Shabat, Niv
AU - Gendelman, Omer
AU - Fisher, Lior
AU - Shani, Uria
AU - Patt, Yonatan Shneor
AU - Watad, Abdulla
AU - Skuja, Vita
AU - McGonagle, Dennis
AU - Amital, Howard
PY - 2023/4/2
Y1 - 2023/4/2
N2 - OBJECTIVE: The association between chronic inflammatory conditions and cardiovascular disease is well established. Considering Familial-Mediterranean-Fever (FMF), few studies exist investigating the risk of ischemic heart disease, and none address the risk of stroke. We aimed to evaluate the incidence and risk for stroke in FMF patients compared to the general population.METHODS: A retrospective cohort study using the electronic database of Clalit Health Services (CHS), the largest health organization in Israel. All FMF patients diagnosed between 2000-2016 were included and matched with control according to age, gender, and place of residence. Follow-up continued until the first diagnosis of stroke or death. The incidence of stroke was compared between the groups using univariate and multivariate models adjusting for cardiovascular risk-factors.RESULTS: 9,769 FMF patients and a similar number of controls were followed up for a median period of 12.5 years. The mean age at the beginning of the follow-up was 25.7 years. 208 FMF patients were diagnosed with stroke compared to 148 controls, resulting in an incidence rate (per 10,000 persons-years) of 19.8 (95%CI 17.2-22.7), and 13.9 (95%CI 11.8 to 16.4) respectively, and a crude HR of 1.42 (95% CI 1.15 to 1.76; p < 0.001). In a multivariate analysis, FMF patients who developed amyloidosis with related or non-related renal failure demonstrated significant stroke risk (HR = 2.16; 95%CI 1.38 to 3.38; P < 0.001), as well as for those who did not develop these complications (HR = 1.32; 95%CI 1.04 to 1.67; P < 0.05).CONCLUSION: FMF patients are at increased risk for stroke regardless of known complications.
AB - OBJECTIVE: The association between chronic inflammatory conditions and cardiovascular disease is well established. Considering Familial-Mediterranean-Fever (FMF), few studies exist investigating the risk of ischemic heart disease, and none address the risk of stroke. We aimed to evaluate the incidence and risk for stroke in FMF patients compared to the general population.METHODS: A retrospective cohort study using the electronic database of Clalit Health Services (CHS), the largest health organization in Israel. All FMF patients diagnosed between 2000-2016 were included and matched with control according to age, gender, and place of residence. Follow-up continued until the first diagnosis of stroke or death. The incidence of stroke was compared between the groups using univariate and multivariate models adjusting for cardiovascular risk-factors.RESULTS: 9,769 FMF patients and a similar number of controls were followed up for a median period of 12.5 years. The mean age at the beginning of the follow-up was 25.7 years. 208 FMF patients were diagnosed with stroke compared to 148 controls, resulting in an incidence rate (per 10,000 persons-years) of 19.8 (95%CI 17.2-22.7), and 13.9 (95%CI 11.8 to 16.4) respectively, and a crude HR of 1.42 (95% CI 1.15 to 1.76; p < 0.001). In a multivariate analysis, FMF patients who developed amyloidosis with related or non-related renal failure demonstrated significant stroke risk (HR = 2.16; 95%CI 1.38 to 3.38; P < 0.001), as well as for those who did not develop these complications (HR = 1.32; 95%CI 1.04 to 1.67; P < 0.05).CONCLUSION: FMF patients are at increased risk for stroke regardless of known complications.
KW - FMF
KW - Atherosclerosis
KW - Cardiovascular disease
KW - Cerebrovascular event
KW - Inflammation
KW - Stroke
UR - https://www-webofscience-com.db.rsu.lv/wos/alldb/full-record/WOS:000970533200001
UR - https://www.mendeley.com/catalogue/7e7c535e-8458-39b0-ac43-e78898b52365/
U2 - 10.1093/rheumatology/kead153
DO - 10.1093/rheumatology/kead153
M3 - Article
C2 - 37004175
SN - 1462-0324
JO - Rheumatology
JF - Rheumatology
ER -
