{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:15:12Z","timestamp":1787019312448,"version":"build-2736575974"},"reference-count":50,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["International Journal of Stroke"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Rheumatoid arthritis (RA) has been associated with an increased stroke risk, but associations by serostatus (seropositive RA (SPRA) vs seronegative RA (SNRA)) and with subtypes of stroke (ischemic stroke (IS) or hemorrhagic stroke (HS)) are not well established. In addition, it is not well-known whether the use of biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b\/tsDMARDs) are associated with altered stroke risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This nationwide cohort study used the Korean National Health Insurance Service database and included participants who were first diagnosed with RA in the period 2010\u20132017 with no previous history of stroke, and who had a health checkup within 2 years before the index date (45,175 RA patients). They were compared (1:3 ratio) with non-RA controls matched by age and sex (135,525 non-RA controls).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Patients with RA had a significantly higher risk of both IS (adjusted hazard ratio (aHR) = 1.47, 95% confidence interval (CI) = 1.36\u20131.58) and HS (aHR = 1.31, 95% CI = 1.15\u20131.50) compared to controls. SPRA patients showed higher risk for both IS (aHR = 1.56, 95% CI = 1.43\u20131.69 SPRA vs aHR = 1.23, 1.08\u20131.41 SNRA) and HS (aHR = 1.40, 95% CI = 1.21\u20131.62 SPRA vs aHR = 1.09, 95% CI = 0.86\u20131.38 SNRA). No difference in stroke risk was observed between bDMARDs users and non-users (aHR = 1.66 for users, aHR = 1.41 for non-users). However, potential differences were noted with tsDMARDs use (aHR = 0.81 for users vs aHR = 1.43 for non-users), although not statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Patients with RA are at significantly greater risk for both IS and HS compared to those without RA, and SPRA patients showed higher risk than SNRA patients. Further studies are required to determine the potential of tsDMARDs in the prevention of stroke in RA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17474930251377174","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T07:05:48Z","timestamp":1756537548000},"page":"398-408","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The association between rheumatoid arthritis and stroke risk by serologic status and stroke subtypes"],"prefix":"10.1177","volume":"21","author":[{"given":"Alicia","family":"Shin","sequence":"first","affiliation":[{"name":"University of California, Los Angeles, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-8955-4264","authenticated-orcid":false,"given":"Seonyoung","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhyung","family":"Jung","sequence":"additional","affiliation":[{"name":"Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In Young","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seonghye","family":"Kim","sequence":"additional","affiliation":[{"name":"International Healthcare Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Yun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8128-8920","authenticated-orcid":false,"given":"Dong Wook","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea"},{"name":"Department of Digital Health, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Republic of Korea"},{"name":"Department of Family Medicine\/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyungjin","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"International Healthcare Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"},{"name":"Department of Medical Humanities, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000481992"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1080\/14397595.2018.1519889"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209315"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/srep05110"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcma.2018.03.009"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000514889"},{"key":"e_1_3_2_8_2","article-title":"Association between ischemic stroke and seropositive rheumatoid arthritis in Korea: a nationwide longitudinal cohort study","volume":"16","author":"Lee DH","year":"2021","unstructured":"Lee DH, Sheen SH, Lee DG, et al. 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