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Rheumatoid Arthritis Linked to Higher Stroke Risk

Risk even higher for ischemic stroke; RA severity and rofecoxib use associated with higher risk

MONDAY, Sept. 8 (HealthDay News) -- Rheumatoid arthritis is associated with an elevated risk of ischemic strokes and other strokes, and measures of arthritis severity help predict stroke, according to research published Aug. 15 in Arthritis Care & Research.

Zurab Nadareishvili, M.D., Ph.D., of Georgetown University Hospital in Washington, D.C., and colleagues analyzed data from a national longitudinal databank of patients with rheumatoid arthritis or non-inflammatory rheumatic disorders. The researchers matched each case of a patient with stroke with up to 20 control subjects.

Individuals with rheumatoid arthritis had an increased risk of all-category stroke (odds ratio, 1.64) and an even greater risk of ischemic stroke (OR, 2.66), the investigators found. Factors associated with an elevated risk in patients with rheumatoid arthritis included comorbid conditions, hypertension, myocardial infarction and use of low-dose aspirin, the researchers report. In addition, total joint replacement and Health Assessment Questionnaire score were associated with the risk of ischemic stroke. Rofecoxib and possibly corticosteroid use were associated with a higher adjusted risk of ischemic stroke, the report indicates.

"This study contributes new information regarding pharmacologic and non-pharmacologic risk factors for stroke in rheumatoid arthritis," the authors write. "Except for rofecoxib, rheumatoid arthritis treatment does not appear to be associated with stroke, although the effect of corticosteroids remains uncertain."

The study was funded by Abbott, Amgen, Wyeth-Australia, Merck and Pfizer. A study co-author disclosed a financial relationship with Bristol-Myers Squibb.

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