{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:49:39Z","timestamp":1789523379234,"version":"build-2803163510"},"reference-count":60,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2020,7,18]],"date-time":"2020-07-18T00:00:00Z","timestamp":1595030400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004325","name":"AstraZeneca","doi-asserted-by":"publisher","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}],"id":[{"id":"10.13039\/100004325","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2020,7,11]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec id=\"s1\">\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the risk of stroke and myocardial infarction (MI) in adult patients with systemic lupus erythematosus (SLE) through a systematic review and meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s2\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched MEDLINE and EMBASE from inception to May 2020 to identify observational studies (cohort and cross-sectional) that evaluated risk of stroke and MI in adult patients with SLE compared with the general population or healthy controls. Studies were included if they reported effect-size estimates that could be used for calculating pooled-effect estimates. Random-effects models were used to calculate pooled risk ratios (RRs) and 95% CIs for stroke and MI. Heterogeneity quantified by the I<jats:sup>2<\/jats:sup> test and sensitivity analyses assessed bias.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s3\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In total, 26 studies were included in this meta-analysis: 14, 5 and 7 studies on stroke, MI and both stroke and MI, respectively. The pooled RR for ischaemic stroke was 2.18 (95% CI 1.78 to 2.67; I<jats:sup>2<\/jats:sup> 75%), intracerebral haemorrhage 1.84 (95% CI 1.16 to 2.90; I<jats:sup>2<\/jats:sup> 67%), subarachnoid haemorrhage 1.95 (95% CI 0.69 to 5.52; I<jats:sup>2<\/jats:sup> 94%), composite stroke 2.13 (95% CI 1.73 to 2.61; I<jats:sup>2<\/jats:sup> 88%) and MI 2.99 (95% CI 2.34 to 3.82; I<jats:sup>2<\/jats:sup> 85%). There was no evidence for publication bias, and sensitivity analyses confirmed the robustness of the results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s4\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Overall, patients with SLE were identified to have a twofold to threefold higher risk of stroke and MI. Future research on the interaction between known SLE-specific modifiable risk factors and risk of stroke and MI to support development of prevention and treatment strategies are needed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"s5\">\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42018098690.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2020-001247","type":"journal-article","created":{"date-parts":[[2020,9,8]],"date-time":"2020-09-08T13:40:19Z","timestamp":1599572419000},"page":"e001247","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":83,"title":["Systemic lupus erythematosus; stroke and myocardial infarction risk: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"6","author":[{"given":"Jinoos","family":"Yazdany","sequence":"first","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, 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