Women with systemic lupus erythematosus are more likely to experience adverse outcomes following stroke than those without, research suggests.

People with idiopathic inflammatory myopathies may be at increased risk for ischemic stroke, suggest findings from a systematic review and meta-analysis.

An elevated systemic inflammatory response index could signal an increased risk for ischemic stroke in patients with rheumatoid arthritis, report Chinese researchers.

Individuals with systemic sclerosis have an elevated risk for ischemic stroke after adjustment for traditional cardiovascular risk factors, study findings suggest.

Immunoglobulin (Ig)G against second-generation cyclic citrullinated peptides (anti-CPP2), the spreading of 20 anti-citrullinated protein antibody (ACPA) fine-specificities, and IgM anti-rheumatoid factor (RF) have previously been linked to the risk for myocardial infarction, stroke, and cardiovascular death, the researchers explain in Rheumatology .

The nested case-control study included 10,475 people with newly diagnosed gout and a subsequent CV event (acute myocardial infarction [MI] or stroke) and 52,099 matched individuals without CV events who were included in a UK primary care database between 1997 and 2020.

Their findings are based on an analysis of national registry data for 942,416 residents of the Auckland/Northland region of Aotearoa New Zealand who were aged 20–79 years with no history of ischemic heart disease, ischemic or hemorrhagic stroke, transient ischemic attack, peripheral vascular disease, or heart failure.

Kristensen commented that there was a “nice dose–response relationship,” between 10-year ASCVD risk and MACE (composite of myocardial infarction, stroke, and CV death) incidence rates, which rose from 0.1 per 100 person–years in those at low risk to 1.3 per 100 person–years in those at high risk.

In all, there were 4196 incidences of MACE (myocardial infarction, stroke, or cardiovascular death) reported: 817 (1.6%) in patients treated with JAK inhibitors and 3379 (1.4%) in those treated with TNF inhibitors.

By comparison, AUC analysis of the QRISK3 10-year risk score for myocardial infarction and stroke, which takes into account SLE, corticosteroid use, chronic renal impairment, and other risk factors, showed “considerably lower” accuracy for predicting CVD events, at 64.7%, says the team.

This announcement is based on a completed FDA review of the ORAL Surveillance safety trial, which found an increased risk for serious CV events such myocardial infarction or stroke, as well as cancer, blood clots, and death among people with rheumatoid arthritis taking tofacitinib versus TNF inhibitors.

When the components of MACE were analyzed separately, similar findings were seen for the outcome of myocardial infarction, but the associations were “less apparent” for stroke, she said.

Similar findings were seen for the secondary outcomes of myocardial infarction, stroke, heart failure, and coronary revascularization in the overall study population, with the nonsignificant HRs ranging from 0.93 to 1.07.

The Hospital Episode Statistics and Office of National Statistics databases were then used to calculate incidence of CVD events, comprising a composite of nonfatal or fatal myocardial infarction, stroke, hospitalization for heart failure, or death from CVD, and all-cause mortality in one cohort of 1768 RA patients taking statins and 3528 patients not taking statins.

As reported in Autoimmunity Reviews , the meta-analysis showed that the risk for symptomatic CV events (myocardial ischemia, stroke, or peripheral artery disease) was a significant 1.98 times higher in people with versus without SLE.

At baseline, patients taking benzbromarone had more CV comorbidities than those taking allopurinol but there was no significant difference between the two groups for the primary composite outcome of coronary revascularization or hospitalization for myocardial infarction, ischemic stroke or transient ischemic attack, for any of the individual components separately, or for hospitalization for heart failure.

Singh says that the primary outcome of the FAST trial was also neutral, with comparable rates of CV death, hospitalization for nonfatal myocardial infarction or biomarker-positive acute coronary syndrome, and nonfatal stroke in the febuxostat and allopurinol groups.

In the on-treatment analysis, 5.6% of 3063 participants treated with febuxostat experienced the primary composite endpoint of CV death, hospitalization for nonfatal myocardial infarction or biomarker-positive acute coronary syndrome, or nonfatal stroke during a median follow-up of 1467 days, compared with 7.9% of 3065 patients given allopurinol.

Overall, 1801 participants experienced the composite outcome of myocardial infarction, stroke, hospitalization for heart failure, or death from CVD during a median follow-up of 4 years, giving an incidence rate of 1.78 per 1000 person–years.