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Immune thrombocytopenia and risk of stroke: Evidence from a nationwide population-based cohort study
Abstract
Background:
Research
investigating differences in the overall stroke risk between
individuals with and without immune thrombocytopenia (ITP) is lacking.
Methods:
This
real-world study used the National Health Insurance Research Database
(NHIRD). Risk of stroke was compared between 13,085 individuals with ITP
enrolled between 1 January 2000 and 31 December 2015 and a control
cohort of 52,340 individuals without ITP (1:4 ratio propensity
score–matched by age, sex, index year, relevant comorbidities, and
medications). Sub-distribution hazards models were used to estimate
adjusted sub-distribution hazard ratio (SHR) and 95% confidence
intervals (CIs), with the non-ITP group as the control group.
Results:
Of
the 65,425 participants, 13,085 had ITP, 63.3% were women, and the mean
age was 52.59 years. The risk of both ischemic and hemorrhagic stroke
was 1.14 times (adjusted SHR 1.14, 95% CI, 1.07–1.22) and 1.93 times
(adjusted SHR 1.93, 95% CI, 1.70–2.20) higher in the ITP group than in
controls. Patients with ITP in the 20- to 29-year subgroup had a higher
risk of new-onset stroke (adjusted SHR, 4.06 (95% CI, 2.72–6.07), p
value for interaction <0.01) than those aged 20–29 years without
ITP. Individuals with severe ITP with splenectomy had a 1.79 times
higher overall stroke risk than those without.
Conclusions:
ITP is associated with increased risk of both ischemic and hemorrhagic stroke.
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