Patients with inflammatory bowel disease are at higher risk for myocardial infarction, according to research published in Inflammatory Bowel Diseases.
Mahazarin Ginwalla, MD, MS, of the Harrington Heart and Vascular Institute at University Hospitals Cleveland Medical Center, and colleagues wrote that chronic inflammation has been recognized as an important factor in the pathogenesis of cardiovascular disease, but there has been some debate about the specific impact of IBD on heart health.
“Given the lack of consensus on this important issue, the large number of patients affected by IBD, the potential impact of increased cardiovascular risk in this population, and the ambiguity of data around this question, we sought to further investigate the association between IBD and the risk of myocardial infarction,” they wrote.
Researchers analyzed from a large database using aggregated medical records from 26 nationwide health care systems and examined the risk for MI in patients with and without IBD.
The cohort comprised more than 29 million patients, including 131,680 with ulcerative colitis and 158,750 with Crohn’s disease. The prevalence of MI was higher among patients with UC (6.7%; OR = 2.09; 95% CI, 2.04–2.13) and CD (8.8%; 2.79;95% CI, 2.74–2.85), compared with patients without IBD (3.3%).
Younger patients (30–34 years) had the highest odds for MI among patients with IBD (OR = 12.05; 95% CI, 11.16–13.01), and the odds decreased with age (65+ years: OR = 2.08; 95% CI, 2.04–2.11).
Ginwalla and colleagues outlined several reasons why patients with IBD might have a higher risk for MI.
“The underlying pro-inflammatory state is a potent stimulus for thrombogenesis and endothelial dysfunction. Activation of the coagulation cascade and pro-inflammatory cytokines due to active intestinal inflammation may also be a contributing factor,” they wrote. “The risk of adverse cardiovascular events is highest during active flares or persistent disease, with this risk diminishing during times of remission. Unfortunately, in our study we are unable to distinguish between active and quiescent IBD.” – by Alex Young
Disclosures: Healio Gastroenterology and Liver Disease was unable to determine the authors’ relative financial disclosures at the time of publication.