Major acute cardiovascular events in patients with inflammatory bowel disease.
Major acute cardiovascular events in patients with inflammatory bowel disease.
- 2021
Available online from MWHC library: February 2000 - present
BACKGROUND: Systemic inflammation and immune-mediated diseases have been associated with ischemic heart disease in addition to traditional risk factors. In this study, we investigate associations between inflammatory bowel disease (IBD) and acute cardiovascular events. CONCLUSIONS: Among patients with IBD, incidence of acute coronary events did not show a statistically significant difference when compared to the matched cohort. METHODS: An observational study where patient data were extracted from our health system patient pool of 3 917 894. Propensity scores were calculated for all 15 292 patients (0.39%) with IBD to assemble a 1:1 matched cohort balanced for age, gender, race and known cardiovascular risk factors including hypertension, hyperlipidemia, diabetes mellitus and smoking (current and former). Secondary analyses were performed independently for 6658 patients with ulcerative colitis and 9406 patients with Crohn's disease. ICD-9 and ICD-10 codes were used to identify cardiovascular risk factors and outcomes. RESULTS: Matched patients (n = 30 584) had a mean age of 51 years, with 58% being women, and 63% Caucasian. During the median follow-up of 4.4 years, all-cause mortality was observed in 1.7 versus 1.2% of patients from IBD and non-IBD groups, respectively [hazard ratio, 1.31; 95% confidence interval (CI), 1.08-1.58; P = 0.005]. Combined outcome for myocardial infarction or cardiovascular mortality was noted in 2.3 and 2.1% from IBD and non-IBD groups, respectively (hazard ratio, 1.04; 95% CI, 0.90-1.21; P = 0.588), while hazard ratios for cardiovascular mortality, myocardial infarction and unstable angina were 1.04 (0.74-1.47; P = 0.833), 1.05 (0.89-1.23; P = 0.591) and 1.10 (0.83-1.46; P = 0.524), respectively.
English
0954-6928
10.1097/MCA.0000000000000899 [doi]
*Acute Coronary Syndrome
*Inflammatory Bowel Diseases
*Myocardial Infarction
Acute Coronary Syndrome/di [Diagnosis]
Acute Coronary Syndrome/mo [Mortality]
Cause of Death
Colitis, Ulcerative/ep [Epidemiology]
Crohn Disease/ep [Epidemiology]
Female
Heart Disease Risk Factors
Humans
Incidence
Inflammatory Bowel Diseases/di [Diagnosis]
Inflammatory Bowel Diseases/ep [Epidemiology]
Inflammatory Bowel Diseases/pp [Physiopathology]
Male
Middle Aged
Mortality
Myocardial Infarction/di [Diagnosis]
Myocardial Infarction/mo [Mortality]
United States/ep [Epidemiology]
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Medicine/Internal Medicine
Journal Article
Available online from MWHC library: February 2000 - present
BACKGROUND: Systemic inflammation and immune-mediated diseases have been associated with ischemic heart disease in addition to traditional risk factors. In this study, we investigate associations between inflammatory bowel disease (IBD) and acute cardiovascular events. CONCLUSIONS: Among patients with IBD, incidence of acute coronary events did not show a statistically significant difference when compared to the matched cohort. METHODS: An observational study where patient data were extracted from our health system patient pool of 3 917 894. Propensity scores were calculated for all 15 292 patients (0.39%) with IBD to assemble a 1:1 matched cohort balanced for age, gender, race and known cardiovascular risk factors including hypertension, hyperlipidemia, diabetes mellitus and smoking (current and former). Secondary analyses were performed independently for 6658 patients with ulcerative colitis and 9406 patients with Crohn's disease. ICD-9 and ICD-10 codes were used to identify cardiovascular risk factors and outcomes. RESULTS: Matched patients (n = 30 584) had a mean age of 51 years, with 58% being women, and 63% Caucasian. During the median follow-up of 4.4 years, all-cause mortality was observed in 1.7 versus 1.2% of patients from IBD and non-IBD groups, respectively [hazard ratio, 1.31; 95% confidence interval (CI), 1.08-1.58; P = 0.005]. Combined outcome for myocardial infarction or cardiovascular mortality was noted in 2.3 and 2.1% from IBD and non-IBD groups, respectively (hazard ratio, 1.04; 95% CI, 0.90-1.21; P = 0.588), while hazard ratios for cardiovascular mortality, myocardial infarction and unstable angina were 1.04 (0.74-1.47; P = 0.833), 1.05 (0.89-1.23; P = 0.591) and 1.10 (0.83-1.46; P = 0.524), respectively.
English
0954-6928
10.1097/MCA.0000000000000899 [doi]
*Acute Coronary Syndrome
*Inflammatory Bowel Diseases
*Myocardial Infarction
Acute Coronary Syndrome/di [Diagnosis]
Acute Coronary Syndrome/mo [Mortality]
Cause of Death
Colitis, Ulcerative/ep [Epidemiology]
Crohn Disease/ep [Epidemiology]
Female
Heart Disease Risk Factors
Humans
Incidence
Inflammatory Bowel Diseases/di [Diagnosis]
Inflammatory Bowel Diseases/ep [Epidemiology]
Inflammatory Bowel Diseases/pp [Physiopathology]
Male
Middle Aged
Mortality
Myocardial Infarction/di [Diagnosis]
Myocardial Infarction/mo [Mortality]
United States/ep [Epidemiology]
MedStar Heart & Vascular Institute
MedStar Washington Hospital Center
Medicine/Internal Medicine
Journal Article