Polymyalgia rheumatica and risk of cerebrovascular accident: A systematic review and meta-analysis

Background: Several chronic inflammatory disorders, such as rheumatoid arthritis and systemic lupus erythematosus, have been linked to an increased risk of cerebrovascular accident (CVA), but the data on polymyalgia rheumatica (PMR) remains unclear. Materials and Methods: We conducted a systematic review and meta-analysis of observational studies that reported odds ratio, relative risk, hazard ratio, or standardized incidence ratio comparing the risk of CVA in patients with PMR versus non-PMR controls. Pooled risk ratio and 95% confidence interval (CI) were calculated using a random-effect, generic inverse variance method of DerSimonian and Laird. Results: Three retrospective cohort studies and one cross-sectional study were identified and included in the data analysis. We found a significantly elevated CVA risk in patients with PMR, with the pooled risk ratio of 1.87 (95% CI, 1.43u2.43). The statistical heterogeneity was high, with an I-2 of 91%. Conclusions: Our study demonstrated a statistically significantly increased CVA risk among patients with PMR.