Evidence map›Paper›PMID 38573365›Full record

SynthesisJournal of neurology2024

Prevalence and epidemiology of stroke in patients with multiple sclerosis: a systematic review and meta-analysis.

Maria-Ioanna Stefanou, Vasileios Giannopapas, Dimitrios K Kitsos, Maria Chondrogianni, Aikaterini Theodorou, Maria Kosmidou, Pinelopi Vlotinou, Christos Bakirtzis, Elizabeth Andreadou, John S Tzartos and 2 more

Open access · hybridAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Comorbidity and modifiable risk factors in multiple sclerosis.Therapeutic advances in neurological disorders · 2026
    Review
  4. Article
  5. Review
  6. Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 1 country.

Maria-Ioanna StefanouSecond Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462, Athens, Greece.
Vasileios GiannopapasSecond Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462, Athens, Greece.
Dimitrios K KitsosSecond Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462, Athens, Greece.
Maria ChondrogianniSecond Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462, Athens, Greece.
Aikaterini TheodorouSecond Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462, Athens, Greece.
Maria KosmidouFaculty of Medicine, Department of Internal Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
Pinelopi VlotinouDepartment of Occupational Therapy, School of Health and Welfare Sciences, University of West Attica, Athens, Greece.
Christos BakirtzisSecond Department of Neurology and the MS Center, AHEPA University Hospital, Central Macedonia, Thessaloniki, Greece.
Elizabeth AndreadouSchool of Medicine, First Department of Neurology, National and Kapodistrian University of Athens, "Eginition" University Hospital, Athens, Greece.
John S TzartosSecond Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462, Athens, Greece.
Sotirios Giannopoulos *Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462, Athens, Greece. sgiannop@uoi.gr.ORCID http://orcid.org/0000-0001-7443-5179
Georgios Tsivgoulis *Second Department of Neurology, School of Medicine, "Attikon" University Hospital, National and Kapodistrian University of Athens, Rimini 1, Chaidari, 12462, Athens, Greece.
National and Kapodistrian University of Athens · GRAHEPA University Hospital · GRUniversity of Ioannina · GRUniversity of West Attica · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEpidemiological data are sparse regarding the risk of stroke in patients with multiple sclerosis (MS).

objectiveTo estimate the following: (1) the pooled prevalence of all-cause stroke, acute ischaemic stroke (AIS) and intracerebral haemorrhage (ICH) in MS patients; (2) the relative risk for all-cause stroke, AIS and ICH in MS patients compared to the general population; (3) associations between patient characteristics and the risk for AIS and ICH in MS patients.

methodsSystematic review and meta-analysis of registry-based and cohort studies.

resultsThirteen observational studies comprising 146,381 MS patients were included. The pooled prevalence of all-cause stroke was 2.7% (95% confidence interval [CI] 1.3-4.6%), with the relative risk of all-cause stroke being higher in MS patients compared to the general population (RR: 2.55; 95% CI 1.97-3.29). Subgroup analyses per stroke subtype revealed a pooled AIS prevalence of 2.1% (95% CI 0.8-4.1%) and a pooled ICH prevalence of 0.6% (95% CI 0.2-1.2%). Compared to the general population, patients with MS were found to harbour an increased risk for AIS (RR: 2.79; 95% CI 2.27-3.41) and ICH (RR: 2.31; 95% CI 1.04-5.11), respectively. The pooled prevalence of cardiovascular risk factors in MS patients was 11.5% (95% CI 2.9-24.7%) for dyslipidaemia, 18.2% (95% CI 5.9-35.3%) for hypertension and 5.4% (95% CI 2.1-10.2%) for diabetes. In meta-regression, age was negatively associated with AIS risk (β =  - .03, p = 0.04), with a 1-year increase in age resulting in a significant 3% (95%CI 0-5) attenuation of the risk of AIS.

conclusionThe findings of the present meta-analysis indicate that MS is associated with an increased risk for ischaemic and haemorrhagic stroke. Future well-designed epidemiological studies are warranted to corroborate the robustness of the present findings in the MS population.

Indexed as

Multiple SclerosisStrokeHumansObservational Studies as TopicPrevalenceRisk FactorsCardiovascular risk factorsCerebrovascular diseaseIntracerebral haemorrhageMultiple sclerosisStroke

Identifiers

PMID38573365
PMCPMC11233381
OpenAlexW4393949677

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.