In the Journals

Patients with IBD at increased risk for ischemic heart disease

Risk for ischemic heart disease was higher among patients with IBD than those without, particularly within 1 year of IBD diagnosis in a recent study.

Researchers compared patients with IBD diagnosed between 1997 and 2009 to those without IBD in a population-based cohort study of nearly 4.6 million people aged 15 years or older in Denmark. Patients with ischemic heart disease (IHD) were identified using the National Patient Register, and incidence RRs for IHD among those with and without IBD were calculated.

IBD was diagnosed in 28,833 patients. IHD, including 97,501 myocardial infarctions (MI), was present in 245,019 patients. Patients with IBD accounted for 1,175 of IHD cases and 436 MI, and they were at an increased risk for developing IHD (IRR=1.59, 1.50-1.69), which grew significantly within 3 months (IRR=4.57, 3.89-5.36) and within 1 year of IBD diagnosis (IRR=2.13, 1.91-2.38). Patients with IBD also were at increased risk for MI within 1 year (IRR=1.88, 1.56-2.28) and after 1 year (IRR=1.17, 1.05-1.30) of diagnosis (95% CI for all).

IHD risk was lower among patients taking 5-aminosalicylic acids (5-ASA) (IRR=1.16, 1.06-1.26) than those who were not (IRR=1.36, 1.22-1.51), with an even smaller risk among long-term (three or more redeemed prescriptions) 5-ASA users (IRR=1.08, 0.98-1.19). The impact of 5-ASA use was affected by patients’ previous use of oral corticosteroids, with a significantly lower risk among corticosteroid users who took 5-ASA (IRR=1.16, 1.04-1.29) than those who did not (IRR=1.71, 1.46-2.01) (95% CI for all).

Women with IBD were at increased risk for IHD compared with men with IBD (IRR=1.33, 1.21-1.46 for women vs. IRR=1.14, 1.04-1.26 for men). Patients with IBD who did not undergo major intestinal surgery were also at increased IHD risk compared with those who had surgery (IRR=1.29, 1.20-1.38 vs. IRR=0.92, 0.75-1.13) (95% CI for all).

“This … study showed a markedly increased risk of IHD and the subentity MI in the first year after IBD diagnosis,” the researchers wrote. “However, a statistically significant, 22% increased long-term risk persisted, suggesting an impact of IBD-related intermittent or chronic systemic inflammation on risk of IHD. Our new findings suggest that lowering the inflammatory burden reduces the risk of IHD in IBD.”

Risk for ischemic heart disease was higher among patients with IBD than those without, particularly within 1 year of IBD diagnosis in a recent study.

Researchers compared patients with IBD diagnosed between 1997 and 2009 to those without IBD in a population-based cohort study of nearly 4.6 million people aged 15 years or older in Denmark. Patients with ischemic heart disease (IHD) were identified using the National Patient Register, and incidence RRs for IHD among those with and without IBD were calculated.

IBD was diagnosed in 28,833 patients. IHD, including 97,501 myocardial infarctions (MI), was present in 245,019 patients. Patients with IBD accounted for 1,175 of IHD cases and 436 MI, and they were at an increased risk for developing IHD (IRR=1.59, 1.50-1.69), which grew significantly within 3 months (IRR=4.57, 3.89-5.36) and within 1 year of IBD diagnosis (IRR=2.13, 1.91-2.38). Patients with IBD also were at increased risk for MI within 1 year (IRR=1.88, 1.56-2.28) and after 1 year (IRR=1.17, 1.05-1.30) of diagnosis (95% CI for all).

IHD risk was lower among patients taking 5-aminosalicylic acids (5-ASA) (IRR=1.16, 1.06-1.26) than those who were not (IRR=1.36, 1.22-1.51), with an even smaller risk among long-term (three or more redeemed prescriptions) 5-ASA users (IRR=1.08, 0.98-1.19). The impact of 5-ASA use was affected by patients’ previous use of oral corticosteroids, with a significantly lower risk among corticosteroid users who took 5-ASA (IRR=1.16, 1.04-1.29) than those who did not (IRR=1.71, 1.46-2.01) (95% CI for all).

Women with IBD were at increased risk for IHD compared with men with IBD (IRR=1.33, 1.21-1.46 for women vs. IRR=1.14, 1.04-1.26 for men). Patients with IBD who did not undergo major intestinal surgery were also at increased IHD risk compared with those who had surgery (IRR=1.29, 1.20-1.38 vs. IRR=0.92, 0.75-1.13) (95% CI for all).

“This … study showed a markedly increased risk of IHD and the subentity MI in the first year after IBD diagnosis,” the researchers wrote. “However, a statistically significant, 22% increased long-term risk persisted, suggesting an impact of IBD-related intermittent or chronic systemic inflammation on risk of IHD. Our new findings suggest that lowering the inflammatory burden reduces the risk of IHD in IBD.”