#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The impact of rehabilitation frequency on the risk of stroke in patients with rheumatoid arthritis


Autoři: Yuan-Yang Cheng aff001;  Shin-Tsu Chang aff001;  Chung-Lan Kao aff002;  Yi-Huei Chen aff007;  Ching-Heng Lin aff007
Působiště autorů: Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taichung, Taiwan aff001;  School of Medicine, National Yang-Ming University, Taipei, Taiwan aff002;  Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei, Taiwan aff003;  School of Medicine, National Defense Medical Center, Taipei, Taiwan aff004;  School of Medicine, Chung Shan Medical University, Taichung, Taiwan aff005;  Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, Taipei, Taiwan aff006;  Department of Medical Research, Taichung Veterans General Hospital, Taichung, Taiwan aff007
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227514

Souhrn

Background

Patients with rheumatoid arthritis are at higher risk of developing stroke due to augmented systemic inflammation. While regular exercise has been shown to reduce inflammation in human subjects, the purpose of our study is to determine whether increased frequency of rehabilitation is protective against stroke or not.

Methods

A total of 16,224 rheumatoid arthritis patients with a catastrophic illness certificate were identified in our database from 2000 to 2006, and 663 of them developed stroke before the end of 2013. After statistically matching for age, sex, and the time interval between the diagnosis of rheumatoid arthritis and stroke, 642 patients without stroke were identified as the control group. Analyses with Student’s t test and Chi-square test were done to compare the clinical characteristics of patients with and without stroke, and logistic regression analysis was then performed to evaluate the odds ratio of stroke.

Results

Higher odds ratio of stroke was revealed in patients with hypertension, diabetes mellitus, and moderate degree of rheumatoid arthritis disease severity. Furthermore, more than 40 rehabilitation sessions per year reduced the risk of developing stroke in patients with moderate disease severity.

Conclusions

Physical activities brought by more rehabilitation sessions are beneficial and should be encouraged in patients with rheumatoid arthritis, particularly for those with higher disease activity but not taking biologic agents.

Klíčová slova:

Exercise – Hemorrhagic stroke – Hyperlipidemia – Hypertension – Inflammatory diseases – Ischemic stroke – Rheumatoid arthritis – stroke


Zdroje

1. Scott DL, Wolfe F, Huizinga TW (2010) Rheumatoid arthritis. Lancet 376: 1094–1108. doi: 10.1016/S0140-6736(10)60826-4 20870100

2. Das S, Padhan P (2017) An Overview of the Extraarticular Involvement in Rheumatoid Arthritis and its Management. J Pharmacol Pharmacother 8: 81–86. doi: 10.4103/jpp.JPP_194_16 29081614

3. Meschia JF, Bushnell C, Boden-Albala B, Braun LT, Bravata DM, et al. (2014) Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 45: 3754–3832. doi: 10.1161/STR.0000000000000046 25355838

4. Meune C, Touze E, Trinquart L, Allanore Y (2010) High risk of clinical cardiovascular events in rheumatoid arthritis: Levels of associations of myocardial infarction and stroke through a systematic review and meta-analysis. Arch Cardiovasc Dis 103: 253–261. doi: 10.1016/j.acvd.2010.03.007 20656636

5. Shekhar S, Cunningham MW, Pabbidi MR, Wang S, Booz GW, et al. (2018) Targeting vascular inflammation in ischemic stroke: Recent developments on novel immunomodulatory approaches. Eur J Pharmacol 833: 531–544. doi: 10.1016/j.ejphar.2018.06.028 29935175

6. Silvagni E, Di Battista M, Bonifacio AF, Zucchi D, Governato G, et al. (2019) One year in review 2019: novelties in the treatment of rheumatoid arthritis. Clin Exp Rheumatol.

7. Pedersen BK (2017) Anti-inflammatory effects of exercise: role in diabetes and cardiovascular disease. Eur J Clin Invest 47: 600–611. doi: 10.1111/eci.12781 28722106

8. Rongen-van Dartel SA, Repping-Wuts H, Flendrie M, Bleijenberg G, Metsios GS, et al. (2015) Effect of Aerobic Exercise Training on Fatigue in Rheumatoid Arthritis: A Meta-Analysis. Arthritis Care Res (Hoboken) 67: 1054–1062.

9. Swardh E, Brodin N (2016) Effects of aerobic and muscle strengthening exercise in adults with rheumatoid arthritis: a narrative review summarising a chapter in Physical activity in the prevention and treatment of disease (FYSS 2016). Br J Sports Med 50: 362–367. doi: 10.1136/bjsports-2015-095793 26843536

10. http://www.tada2002.org.tw/tada_know_02.html (Accessed on June 10 2019) The epidemiological report of the dementia patients in Taiwan. Taiwan Alzheimer Disease Association.

11. Hsieh CY, Su CC, Shao SC, Sung SF, Lin SJ, et al. (2019) Taiwan's National Health Insurance Research Database: past and future. Clin Epidemiol 11: 349–358. doi: 10.2147/CLEP.S196293 31118821

12. Medicine ACoS (2017) ACSM's Guidelines for Exercise Testing and Prescription 10th edition. Lippincott Williams and Wilkins. pp. 321–322.

13. Vinet E, Kuriya B, Widdifield J, Bernatsky S (2011) Rheumatoid arthritis disease severity indices in administrative databases: a systematic review. J Rheumatol 38: 2318–2325. doi: 10.3899/jrheum.110587 21921094

14. Toledano E, Garcia de Yebenes MJ, Gonzalez-Alvaro I, Carmona L (2019) Severity indices in rheumatoid arthritis: A systematic review. Reumatol Clin 15: 146–151. doi: 10.1016/j.reuma.2017.07.004 28807652

15. Ting G, Schneeweiss S, Scranton R, Katz JN, Weinblatt ME, et al. (2008) Development of a health care utilisation data-based index for rheumatoid arthritis severity: a preliminary study. Arthritis Res Ther 10: R95. doi: 10.1186/ar2482 18717997

16. Cabral D, Katz JN, Weinblatt ME, Ting G, Avorn J, et al. (2005) Development and assessment of indicators of rheumatoid arthritis severity: results of a Delphi panel. Arthritis Rheum 53: 61–66. doi: 10.1002/art.20925 15696560

17. Wolfe F, Michaud K, Simon T (2006) Can severity be predicted by treatment variables in rheumatoid arthritis administrative data bases? J Rheumatol 33: 1952–1956. 16960927

18. van Riel PL, Renskers L (2016) The Disease Activity Score (DAS) and the Disease Activity Score using 28 joint counts (DAS28) in the management of rheumatoid arthritis. Clin Exp Rheumatol 34: S40–s44.

19. Tang KT, Chen YH, Lin CH, Chen DY (2016) Methotrexate is not associated with increased liver cirrhosis in a population-based cohort of rheumatoid arthritis patients with chronic hepatitis C. Sci Rep 6: 33104. doi: 10.1038/srep33104 27609026

20. Tang KT, Hung WT, Chen YH, Lin CH, Chen DY (2016) Methotrexate is not associated with increased liver cirrhosis in a population-based cohort of rheumatoid arthritis patients with chronic hepatitis B. Sci Rep 6: 22387. doi: 10.1038/srep22387 26928373

21. Tiosano S, Yavne Y, Gendelman O, Watad A, Comaneshter D, et al. (2017) Stroke among Rheumatoid Arthritis Patients: Does Age Matter? A Real-Life Study. Neuroepidemiology 49: 99–105. doi: 10.1159/000481992 29136635

22. Semb AG, Kvien TK, Aastveit AH, Jungner I, Pedersen TR, et al. (2010) Lipids, myocardial infarction and ischaemic stroke in patients with rheumatoid arthritis in the Apolipoprotein-related Mortality RISk (AMORIS) Study. Ann Rheum Dis 69: 1996–2001. doi: 10.1136/ard.2009.126128 20551156

23. Wiseman SJ, Ralston SH, Wardlaw JM (2016) Cerebrovascular Disease in Rheumatic Diseases: A Systematic Review and Meta-Analysis. Stroke 47: 943–950. doi: 10.1161/STROKEAHA.115.012052 26917565

24. Chen YR, Hsieh FI, Lien LM, Hu CJ, Jeng JS, et al. (2018) Rheumatoid arthritis significantly increased recurrence risk after ischemic stroke/transient ischemic attack. J Neurol 265: 1810–1818. doi: 10.1007/s00415-018-8885-9 29860668

25. Wu MH, Huang CC, Chio CC, Tsai KJ, Chang CP, et al. (2016) Inhibition of Peripheral TNF-alpha and Downregulation of Microglial Activation by Alpha-Lipoic Acid and Etanercept Protect Rat Brain Against Ischemic Stroke. Mol Neurobiol 53: 4961–4971. doi: 10.1007/s12035-015-9418-5 26374550

26. Kerekes G, Soltesz P, Szucs G, Szamosi S, Der H, et al. (2011) Effects of adalimumab treatment on vascular disease associated with early rheumatoid arthritis. Isr Med Assoc J 13: 147–152. 21608334

27. Kerekes G, Soltesz P, Der H, Veres K, Szabo Z, et al. (2009) Effects of rituximab treatment on endothelial dysfunction, carotid atherosclerosis, and lipid profile in rheumatoid arthritis. Clin Rheumatol 28: 705–710. doi: 10.1007/s10067-009-1095-1 19319624

28. Metsios GS, Stavropoulos-Kalinoglou A, Kitas GD (2015) The role of exercise in the management of rheumatoid arthritis. Expert Rev Clin Immunol 11: 1121–1130. doi: 10.1586/1744666X.2015.1067606 26178249

29. Turesson C, Matteson EL (2007) Cardiovascular risk factors, fitness and physical activity in rheumatic diseases. Curr Opin Rheumatol 19: 190–196. doi: 10.1097/BOR.0b013e3280147107 17278937

30. Suissa S (2008) Immortal time bias in pharmaco-epidemiology. Am J Epidemiol 167: 492–499. doi: 10.1093/aje/kwm324 18056625

31. Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, et al. (2018) 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 39: 3021–3104. doi: 10.1093/eurheartj/ehy339 30165516

32. (2019) 5. Lifestyle Management: Standards of Medical Care in Diabetes-2019. Diabetes Care 42: S46–s60. doi: 10.2337/dc19-S005 30559231

33. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, et al. (2018) 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol.


Článek vyšel v časopise

PLOS One


2020 Číslo 1
Nejčtenější tento týden
Nejčtenější v tomto čísle
Kurzy

Zvyšte si kvalifikaci online z pohodlí domova

KOST
Koncepce osteologické péče pro gynekology a praktické lékaře
nový kurz
Autoři: MUDr. František Šenk

Sekvenční léčba schizofrenie
Autoři: MUDr. Jana Hořínková

Hypertenze a hypercholesterolémie – synergický efekt léčby
Autoři: prof. MUDr. Hana Rosolová, DrSc.

Svět praktické medicíny 5/2023 (znalostní test z časopisu)

Imunopatologie? … a co my s tím???
Autoři: doc. MUDr. Helena Lahoda Brodská, Ph.D.

Všechny kurzy
Kurzy Podcasty Doporučená témata Časopisy
Přihlášení
Zapomenuté heslo

Zadejte e-mailovou adresu, se kterou jste vytvářel(a) účet, budou Vám na ni zaslány informace k nastavení nového hesla.

Přihlášení

Nemáte účet?  Registrujte se

#ADS_BOTTOM_SCRIPTS#