Prognosis after first-time myocardial infarction in patients with inflammatory bowel disease according to disease activity: nationwide cohort study

Søren Lund Kristensen, Ole Ahlehoff, Jesper Lindhardsen, Rune Erichsen, Morten Lamberts, Usman Khalid, Ole Haagen Nielsen, Christian Torp-Pedersen, Gunnar Hilmar Gislason, Peter Riis Hansen

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    Abstrakt

    BACKGROUND: Inflammatory bowel disease (IBD) is associated with increased cardiovascular risk. We examined the effect of active IBD on major adverse cardiovascular outcomes after myocardial infarction (MI).

    METHODS AND RESULTS: In nationwide registries, we identified 86 790 patients with first-time MI from the period 2002 to 2011. A total of 1030 patients had IBD, and we categorized their disease activity stages into either flare (120 days), persistent (>120 days) activity, or remission. Short-term mortality was estimated in a logistic regression-model, whereas risk of recurrent MI, all-cause mortality, and a composite of recurrent MI, cardiovascular death, and stroke were estimated by Cox regression-models. Odds ratio of death during hospitalization or within 30 days of discharge (n=13 339) corresponded to 3.29 (95% confidence interval [CI], 1.98-5.45) for patients in IBD flares, 1.62 (95% CI, 0.95-2.77) for persistent activity, and 0.97 (95% CI, 0.78-1.19) for remission when compared with the non-IBD group. Among 73 451 patients, including 863 with IBD, alive 30 days after discharge, IBD was associated with hazard ratios of 1.21 (95% CI, 0.99-1.49) for recurrent MI, 1.14 (95% CI, 1.01-1.28) for all-cause mortality, and 1.17 (95% CI, 1.03-1.34) for the composite end point. When compared with the non-IBD group, IBD flares, in particular, were associated with increased risks of recurrent MI (hazard ratio, 3.09; 95% CI, 1.79-5.32), all-cause mortality (hazard ratio, 2.25; 95% CI, 1.61-3.15), and the composite end point (hazard ratio, 2.04; 95% CI, 1.35-3.06), whereas no increased risk was identified in remission.

    CONCLUSIONS: Active inflammatory bowel disease worsens prognosis after MI, in particular, in relation with flares.

    OriginalsprogEngelsk
    TidsskriftCirculation. Cardiovascular Quality and Outcomes
    Vol/bind7
    Udgave nummer6
    Sider (fra-til)857-862
    ISSN1941-7713
    DOI
    StatusUdgivet - 2014

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