Table 1

Characteristics of studies included in the systematic review to assess risk of stroke and MI in adult patients with SLE compared with the general population or healthy controls

Author/yearStudy designCountryStudy periodSource of SLE populationSource of comparison groupNumber of patients SLE; controlInclusion of fatal/non‑fatal events% Female SLE populationMean/median age (years) SLE; controlOverall estimate risk of biasOutcomes reportedRelative risk measure reported
Arkema 201728Cohort studySweden2003–2013National Patient RegisterTotal population register3390; 16 730Fatal and/or non-fatal85%50; 49LowIschaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, unspecified stroke, composite strokeRate difference
Avina-Zubieta 201729Cohort studyCanada1996–2010Population data British ColumbiaSame as SLE4912; 49 611Fatal and/or non-fatal86%49; 49LowIschaemic stroke, MIHR
Barnado 201848Cohort studyUSANRThe Synthetic Derivative (SD) database of Vanderbilt University, TennesseeSame as SLE1097; 5735Non-fatal90%40; NRLowMIOR
Bengtsson 201230Cohort studySweden2001–200719 specialist departments, 140 primary healthcare centres and one private practiceNational Board of Health and Statistics Sweden275; 517Fatal and/or non-fatal85%51; 48LowComposite stroke, MISIR
Bernatsky 2006a6Cohort studyMultinational1958–200123 collaborating lupus centres in seven countriesPopulation rates (SMR)9547; NAFatal90%NRLowComposite strokeSMR
Bernatsky 2006b5Cohort studyCanada1958–200110 collaborating CaNIOS lupus centres across CanadaPopulation rates (SMR)2688; NAFatal90%NRModerateIschaemic stroke, subarachnoid haemorrhage, composite strokeSMR
Björnådal 20047Cohort studySweden1964–1995The Hospital Discharge RegisterCause of death register (SMR)4737; NAFatal78%NRModerateComposite strokeSMR
Chang 201331Cohort studyTaiwan2000–2006National Health Insurance research databaseSame as SLE16 967; 16 967Fatal and/or non-fatal90%36; 36LowSubarachnoid haemorrhageIRR
Chiu 201232Cohort studyTaiwan2000–2007National Health Insurance research databaseSame as SLE11 637; 58 185Non-fatal89%41; 41LowIschaemic strokeHR
Cook 201849Cohort studyUK2007–2010UK BiobankSame as SLE559; 2236Non-fatal89%56; NRHighComposite stroke/MIHR (and SMR)
Dregan 201733Cross-sectional studyUK2006–2010UK BiobankSame as SLE654; 483 559Fatal and/or non-fatal89%42; 57HighComposite strokeRR
Faurschou 201134Cohort studyDenmark1977–2006Danish SLE cohort established in 1995 and recruited from eight clinical centresDanish National Hospital Register (event rate calculated for background population)104; NAFatal and/or non-fatal80%31; NRLowMIO:E ratio (95% CI)
Hak 200935Cohort studyUSA1976–2004Nurses’ Health StudySame as SLE148; 108 968Fatal and/or non-fatal100%56; 56LowComposite stroke, MIRate ratio
Hermansen 201736Cohort studyDenmark1995–2011The Danish National Patient Registry & Danish Register of Causes of DeathSame as SLENR; NRFatal and/or non-fatal86%48 (no LN), 40 (with LN); 48 (no LN), 40 (with LN)LowComposite stroke, MIHR
Kim 201737Cohort studyUSA1999–2016Explorys platform (26 US healthcare systems)Same as SLE95 400; 45 189 140Non-fatal89%NRLowMIRelative risk
Krishnan 200538Cross-sectional studyUSA2001–2002Healthcare Cost and Utilization Project—Nationwide Inpatient SampleSame as SLE (hospitalisations without mention of lupus)25 704; 3 130 405Non-fatal90%38; 38HighIschaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, composite strokeOR
Lim 201850Cohort studySouth Korea2008–2014Korean National Health Insurance Service (NHIS) databaseSame as SLE18 575; 92 875Non-fatal91%NRLowComposite stroke/MIHR
Lin 201439Cohort studyTaiwan2000–2004National Health Insurance Research DatabaseSame as SLE1207; 9656Fatal and/or non-fatal82%NRLowMIIRR
Liou 201440Cohort studyTaiwan2004–2007The Longitudinal Health Insurance Database 2005 and Registry for BeneficiariesSame as SLE621; 2484Non-fatal89%NRLowIschaemic stroke, composite strokeHR
Manzi 199741Cohort studyUSA1980–1993The University of Pittsburgh Medical CenterFramingham Offspring Study498; 2208Non-fatal100%NRLowMIRelative risk
Mok 200942Cohort studyChina (Hong Kong)1999–2007Tuen Mun HospitalExpected from regional population490; 1 060 000Fatal and/or non-fatal92%33; NRHighIschaemic stroke, intracerebral haemorrhage, composite strokeSIR
Ramagopalan 201343Cohort studyEngland1999–2011Hospital Episode StatisticsSame as SLE25 576; NRFatal and/or non-fatal86%NRLowSubarachnoid haemorrhageRate ratio
Rees 201644Cohort studyUK1999–2012Clinical Practice Research DatalinkSame as SLE7033; 26 683Non-fatal86%48; 48LowComposite strokeIRR
Wang 201245Cohort studyTaiwan1997–2008Taiwan’s National Health Insurance research databaseSame as SLE13 689; 54 756Non-fatal88%35; 35LowIschaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage haemorrhagic stroke, composite strokeHR
Ward 199947Cross-sectional studyUSA1991–1994California Office of Statewide Health Planning and DevelopmentSame as SLENR; NRNon-fatal100%NRHighComposite stroke, MIHR
Zoller 201246Cohort studySweden1987–2008Several national Swedish data registersPopulation rates4179; NRNon-fatal82%NRLowIschaemic stroke, intracerebral haemorrhageSIR
  • CaNIOS, Canadian Network for Improved Outcomes in Systemic Lupus Erythematosus; IRR, incident rate ratio; LN, lupus nephritis; MI, myocardial infarction; NA, not applicable; NR, not reported; O:E ratio, ratio of observed to expected events; RR, risk ratio; SIR, standardised incidence ratio; SLE, systemic lupus erythematosus; SMR, standardised mortality ratio.