Acute Arterial Events Associated With Inflammatory Bowel Disease

Patients with inflammatory bowel disease (IBD) have an increased risk for incident and premature acute arterial events, according to study findings published in Clinical Gastroenterology and Hepatology.

Researchers sourced data from the United Kingdom Biobank on patients from England, Scotland, and Wales between 2006 and 2010; follow-up data was available through July 2021. Of 502,447 patients in the biobank, researchers included 455,950 individuals for the study. Patients with IBD (n=5094) were matched to patients without IBD (n=20,376; control group). Among the patients who had IBD, 60.3% had ulcerative colitis (UC), 28.2% had Crohn disease (CD), and 13.5% had both diagnoses.

The primary outcome was a composite acute arterial events, including ischemic heart disease, cerebrovascular disease, peripheral vascular disease events, and acute arterial event-related death.

At 12.4 years’ follow-up, the rate of incident composite acute arterial events was greater in patients with IBD compared with the control group (924.1 vs 730.9 per 100,000 person-years [PY]; incident rate ratio [IRR], 1.31; 95% CI, 1.25-1.38; P <.001). Patients with IBD developed incident composite acute arterial events more quickly compared with the control group (P ≤.001).

The 5-year risk of developing composite acute arterial events was higher in the IBD group vs the control group (3.83% vs 3.16%). The rate of ischemic heart disease was higher in patients with IBD compared with the control group (711.1 vs 571.4 per 100,000 PY; P ≤.001).

To examine risk for premature acute arterial events, researchers matched 3,129 participants with IBD to 12,516 control individuals. The IBD group had a higher incidence rate of composite premature acute arterial events than the control group (406.8 vs 326.1 per 100,000 PY; IRR, 1.41; 95% CI, 1.14-1.75; P =.001).

Subtype analysis indicated that patients with UC experienced composite acute arterial events faster than the control group (P <.001). However, patients with CD developed premature acute arterial events within a shorter time period than the control group (P =0.029).

Study limitations include a small fraction of reported use of biologic drugs; the inability to assess changes in covariates, such as dietary habits and physical activity, and the possibility of residual confounding.

“Our study adds to the increasing body of evidence demonstrating the unmet need for early identification of those at a higher risk [for] AAEs [acute arterial events] towards primary and secondary prevention of AAEs [acute arterial events]….” the study authors concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.