ArticleAnnals of the rheumatic diseases2017
Serious adverse events and the risk of stroke in patients with rheumatoid arthritis: results from the German RABBIT cohort.
Article in Annals of the rheumatic diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- Genetic Liability to Rheumatoid Arthritis in Relation to Coronary Artery Disease and Stroke Risk.Arthritis & rheumatology (Hoboken, N.J.) · 2022Pooled it
- Safety of biological therapy in patients with rheumatoid arthritis in administrative health databases: A systematic review and meta-analysis.Frontiers in pharmacology · 2022Pooled it
- Stroke in autoimmune rheumatic diseases.Rheumatology international · 2026Review
- Aspirin does not confer protection against major ischemic vascular events in patients diagnosed with rheumatoid arthritis.The Journal of international medical research · 2025Article
- [Rheumatological care in Germany : Memorandum of the German Society for Rheumatology and Clinical Immunology 2024].Zeitschrift fur Rheumatologie · 2024Article
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- Association between rheumatoid arthritis and atrial fibrillation: A systematic review and meta-analysis.Journal of arrhythmia · 2024Review
- Prediction of Major Adverse Cardiovascular Events by Triglyceride Glucose Index in Predominantly Male Patients with Rheumatoid Arthritis.Reviews in cardiovascular medicine · 2024Article
- Increased Risk of Cardiovascular Diseases in Rheumatoid Arthritis: A Systematic Review.Cureus · 2022Review
- [Celebrating 33 years of the DRFZ: Epidemiology and Health Services Research].Zeitschrift fur Rheumatologie · 2022Review
- [Treatment of rheumatoid arthritis and spondylarthritis with biologics].Der Internist · 2022Review
- Pathophysiologic mechanisms of cerebral endotheliopathy and stroke due to Sars-CoV-2.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2021Review
- [Register and cohort studies : Overview of the most important data sources at the German Rheumatism Research Center].Zeitschrift fur Rheumatologie · 2020Review
- [Perspectives for rheumatological health services research at the German Rheumatism Research Center].Zeitschrift fur Rheumatologie · 2020Review
- Outcomes of acute cardiovascular events in rheumatoid arthritis and systemic lupus erythematosus: a population-based study.Rheumatology (Oxford, England) · 2020Article
- Biological therapy safety in chronic inflammatory arthropathy patients.European journal of rheumatology · 2020Article
- Low serum IGF1 is associated with hypertension and predicts early cardiovascular events in women with rheumatoid arthritis.BMC medicine · 2019Observational
- [Cardiovascular comorbidities in rheumatoid arthritis].Zeitschrift fur Rheumatologie · 2019Review
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn the general population, the incidence of stroke is increased following other serious events and hospitalisation. We investigated the impact of serious adverse events on the risk of stroke in patients with rheumatoid arthritis (RA), taking risk factors and treatment into account.
methodsUsing data of the German biologics register RABBIT (Rheumatoid Arthritis: Observation of Biologic Therapy) with 12354 patients with RA, incidence rates (IRs) and risk factors for stroke were investigated using multi-state and Cox proportional hazard models. In addition, in a nested case-control study, all patients with stroke were matched 1:2 to patients with identical baseline risk profile and analysed using a shared frailty model.
resultsDuring follow-up, 166 strokes were reported. The overall IR was 3.2/1000 patient-years (PY) (95% CI 2.7 to 3.7). It was higher after a serious adverse event (IR: 9.0 (7.3 to 11.0)), particularly within 30 days after the event (IR: 94.9 (72.6 to 121.9)). The adjusted Cox model showed increased risks of age per 5 years (HR: 1.4 (1.3 to 1.5)), hyperlipoproteinaemia (HR: 1.6 (1.0 to 2.5)) and smoking (HR: 1.9 (1.3 to 2.6)). The risk decreased with better physical function (HR: 0.9 (0.8 to 0.96)). In the case-control study, 163 patients were matched to 326 controls. Major risk factors for stroke were untreated cardiovascular disease (HR: 3.3 (1.5 to 7.2)) and serious infections (HR:4.4 (1.6 to 12.5)) or other serious adverse events (HR: 2.6 (1.4 to 4.8)).
conclusionsIncident adverse events, in particular serious infections, and insufficient treatment of cardiovascular diseases are independent drivers of the risk of stroke. Physicians should be aware that patients who experience a serious event are at increased risk of subsequent stroke.
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