TY - JOUR
T1 - Inflammatory Bowel Disease Is Associated With an Increased Risk of Incident Acute Arterial Events
T2 - Analysis of the United Kingdom Biobank
AU - Alayo, Quazim A.
AU - Loftus, Edward V.
AU - Yarur, Andres
AU - Alvarado, David
AU - Ciorba, Matthew A.
AU - de las Fuentes, Lisa
AU - Deepak, Parakkal
N1 - Publisher Copyright:
© 2023 AGA Institute
PY - 2023/3
Y1 - 2023/3
N2 - Background & Aims: Population-based studies have suggested an increased risk of acute arterial events (AAEs) in patients with inflammatory bowel disease (IBD). We aimed to assess the risk of incident AAEs and premature AAEs, adjusted for diet, physical activity, and inflammation biomarkers, in participants with IBD in the UK Biobank (UKB) Methods: UKB participants with IBD and without prevalent AAEs at enrollment were matched to random non-IBD controls. A Cox regression model, adjusting for baseline cardiovascular and IBD risk factors, diet, physical activity, and high-sensitivity C-reactive protein, estimated adjusted hazard ratios (aHRs) for association between IBD and AAEs or premature AAEs (age, <55 years for men and <65 years for women). Predictors of AAEs within the IBD cohort were identified in a Cox model adjusting for disease severity (IBD-related hospitalizations or surgeries). Results: Among 455,950 UKB participants, 5094 with IBD were matched to 20,376 non-IBD controls. After a median follow-up period of 12.4 years, participants with IBD had a higher incident rate of AAE (924.1 vs 730.9 per 100,000 person years; P < .001), risk of all AAEs (aHR, 1.19; 95% CI, 1.08–1.31; P < .001), and premature AAEs (aHR, 1.38; 95% CI, 1.11–1.72; P = .001). High-sensitivity C-reactive protein levels (highest quartile: aHR, 1.53; 95% CI, 1.15–2.03) and disease severity (aHR, 5.40; 95% CI, 4.03–7.22) were independent predictors of AAE in IBD. Conclusions: In a prospective cohort, there was an increased risk of incident AAEs and premature AAEs in IBD participants. Beyond traditional AAE risk factors, quantifiable indices of IBD disease activity and severity were independent predictors of AAEs.
AB - Background & Aims: Population-based studies have suggested an increased risk of acute arterial events (AAEs) in patients with inflammatory bowel disease (IBD). We aimed to assess the risk of incident AAEs and premature AAEs, adjusted for diet, physical activity, and inflammation biomarkers, in participants with IBD in the UK Biobank (UKB) Methods: UKB participants with IBD and without prevalent AAEs at enrollment were matched to random non-IBD controls. A Cox regression model, adjusting for baseline cardiovascular and IBD risk factors, diet, physical activity, and high-sensitivity C-reactive protein, estimated adjusted hazard ratios (aHRs) for association between IBD and AAEs or premature AAEs (age, <55 years for men and <65 years for women). Predictors of AAEs within the IBD cohort were identified in a Cox model adjusting for disease severity (IBD-related hospitalizations or surgeries). Results: Among 455,950 UKB participants, 5094 with IBD were matched to 20,376 non-IBD controls. After a median follow-up period of 12.4 years, participants with IBD had a higher incident rate of AAE (924.1 vs 730.9 per 100,000 person years; P < .001), risk of all AAEs (aHR, 1.19; 95% CI, 1.08–1.31; P < .001), and premature AAEs (aHR, 1.38; 95% CI, 1.11–1.72; P = .001). High-sensitivity C-reactive protein levels (highest quartile: aHR, 1.53; 95% CI, 1.15–2.03) and disease severity (aHR, 5.40; 95% CI, 4.03–7.22) were independent predictors of AAE in IBD. Conclusions: In a prospective cohort, there was an increased risk of incident AAEs and premature AAEs in IBD participants. Beyond traditional AAE risk factors, quantifiable indices of IBD disease activity and severity were independent predictors of AAEs.
KW - Cardiovascular Disease
KW - Cerebrovascular Disease
KW - Inflammatory Bowel Disease
KW - Peripheral Arterial Disease
UR - http://www.scopus.com/inward/record.url?scp=85144105618&partnerID=8YFLogxK
U2 - 10.1016/j.cgh.2022.08.035
DO - 10.1016/j.cgh.2022.08.035
M3 - Article
C2 - 36075499
AN - SCOPUS:85144105618
SN - 1542-3565
VL - 21
SP - 761-770.e13
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 3
ER -