TY - JOUR
T1 - Atopic diseases/diathesis and subsequent ischemic stroke among patients with bipolar disorder
T2 - A nationwide longitudinal study
AU - Chen, Li Chi
AU - Chen, Mu Hong
AU - Su, Tung Ping
AU - Tsai, Shih Jen
AU - Bai, Ya Mei
AU - Li, Cheng Ta
AU - Yang, Albert C.
AU - Chang, Wen Han
AU - Chen, Tzeng Ji
N1 - Publisher Copyright:
© 2018 Chen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2018/8
Y1 - 2018/8
N2 - Introduction Previous studies have suggested that both bipolar disorder and atopy are associated with an increased risk of stroke. However, the role of atopic diseases/diathesis in the risk of stroke among patients with bipolar disorder remains unclear. Methods Using Taiwan’s National Health Insurance Research Database, we selected 55,593 patients with bipolar disorder between 2002 and 2008, divided them into patients with atopic diseases/diathesis (n = 21,050) and patients without atopic diseases/diathesis (n = 34,543), and observed them until the end of 2011. Patients who experienced a stroke during the follow-up period were identified. Results Patients with bipolar disorder and atopic diseases/diathesis had an elevated risk of ischemic stroke (hazard ratio [HR]: 1.44, 95% confidence interval [CI]: 1.25–1.59) compared with patients with only bipolar disorder; a dose-dependent relationship was observed between the number of allergic comorbidities and the risk of ischemic stroke (1 atopic disease, HR: 1.30, 95% CI: 1.13–1.49; 2 atopic diseases, HR: 1.59, 95% CI: 1.33–1.91; 3 atopic diseases, HR: 2.09, 95% CI: 1.50–2.91).The role of atopic diseases in the risk of hemorrhagic stroke among patients with bipolar disorder was nonsignificant (HR: 0.84, 95% CI: 0.64–1.09). Conclusions Patients with bipolar disorder and atopic diseases/diathesis are more prone to ischemic stroke later in life than are those without atopic diseases/diathesis. Further study is required to investigate the underlying mechanism linking atopy, bipolar disorder, and stroke.
AB - Introduction Previous studies have suggested that both bipolar disorder and atopy are associated with an increased risk of stroke. However, the role of atopic diseases/diathesis in the risk of stroke among patients with bipolar disorder remains unclear. Methods Using Taiwan’s National Health Insurance Research Database, we selected 55,593 patients with bipolar disorder between 2002 and 2008, divided them into patients with atopic diseases/diathesis (n = 21,050) and patients without atopic diseases/diathesis (n = 34,543), and observed them until the end of 2011. Patients who experienced a stroke during the follow-up period were identified. Results Patients with bipolar disorder and atopic diseases/diathesis had an elevated risk of ischemic stroke (hazard ratio [HR]: 1.44, 95% confidence interval [CI]: 1.25–1.59) compared with patients with only bipolar disorder; a dose-dependent relationship was observed between the number of allergic comorbidities and the risk of ischemic stroke (1 atopic disease, HR: 1.30, 95% CI: 1.13–1.49; 2 atopic diseases, HR: 1.59, 95% CI: 1.33–1.91; 3 atopic diseases, HR: 2.09, 95% CI: 1.50–2.91).The role of atopic diseases in the risk of hemorrhagic stroke among patients with bipolar disorder was nonsignificant (HR: 0.84, 95% CI: 0.64–1.09). Conclusions Patients with bipolar disorder and atopic diseases/diathesis are more prone to ischemic stroke later in life than are those without atopic diseases/diathesis. Further study is required to investigate the underlying mechanism linking atopy, bipolar disorder, and stroke.
UR - http://www.scopus.com/inward/record.url?scp=85053414401&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0200682
DO - 10.1371/journal.pone.0200682
M3 - Article
C2 - 30114239
AN - SCOPUS:85053414401
SN - 1932-6203
VL - 13
JO - PLoS ONE
JF - PLoS ONE
IS - 8
M1 - e0200682
ER -