TOPLINE
Systemic lupus erythematosus (SLE) was associated with an increased risk for stroke, including both ischemic and hemorrhagic stroke.
METHODOLOGY
- Researchers conducted a systematic review and meta-analysis of 25 cohort studies to examine the risk for stroke in patients with SLE.
- A total of 5,220,837 individuals were included, comprising 1,408,205 patients with SLE and 3,812,632 control individuals.
- The analysis assessed the risk for composite stroke, ischemic stroke, and hemorrhagic stroke in patients with SLE.
- The quality of studies was assessed using the Newcastle-Ottawa Quality Assessment Scale; seven studies were of moderate quality, and 18 studies were of high quality.
TAKEAWAY
- Patients with SLE had a significantly increased risk for any stroke (pooled risk ratio [RR], 2.60; 95% CI, 2.21-3.05; I² = 97.9%).
- SLE was associated with an increased risk for composite stroke (pooled RR, 2.83; 95% CI, 2.25-3.57; I² = 98.0%; 15 studies).
- SLE was also associated with an increased risk for ischemic stroke (pooled RR, 2.34; 95% CI, 1.75-3.12; I² = 97.6%; 15 studies) and hemorrhagic stroke (pooled RR, 2.66; 95% CI, 1.57-4.49; I² = 96.2%; eight studies).
IN PRACTICE
“[The] results strongly confirm that SLE represents an independent and substantial risk factor for all stroke subtypes,” the authors wrote.
SOURCE
The study was led by Jingya Zhang, Zhejiang Chinese Medical University in Hangzhou, China. It was published online on September 15 in Lupus Science & Medicine.
LIMITATIONS
Most studies adjusted for major cardiovascular risk factors, though residual confounding may have persisted. The definitions of SLE and stroke relied on administrative codes, which may have caused misclassification. Hemorrhagic stroke was reported in only eight studies, thereby limiting the precision of the estimate. Subgroup analysis by lupus nephritis status was not conducted because only two studies provided the specific data.
DISCLOSURES
This study was supported by the National Natural Science Foundation of China, the National Natural Science Foundation of China Joint Fund for Regional Innovation and Development, the Hangzhou Natural Science Foundation, and other sources. The authors reported no competing interests.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.

