Stroke Risk Highest in the First Year of Lupus Save

Arkema et al has published in Annals of Rheumatic Disease a study showing that ischaemic and haemorrhagic stroke (CVA) is elevated in systemic lupus erythematosus (SLE) compared with the general population, especially in the first year. 

Using the Swedish National Patient Register (NPR, n=3390) with the general population comparators from the Total Population Register (n=16730), they identified SLE and non-SLE patients with CVA and followed prospectively until first of death.

They identified 126 strokes in SLE and 304 in the general population. SLE patients had a twofold increased rate of CVA (HR 2.2; 95% CI 1.7 to 2.8). The HR for intracerebral haemorrhage was 1.4 (95% CI 0.7 to 2.8). This finding was accentuated in females and individuals <50 years old. The HR for ischaemic stroke was highest in the first year of follow-up (3.7; 95% CI 2.1 to 6.5).

The risk of CVA in SLE was more than doubled compared to the general population.  The risk was highets within the first year after SLE diagnosis. The newly presenting SLE patients represents an opportunity to screen for risk factors for CVA.