A STRONG LINK between inflammatory bowel disease (IBD) and myocardial infarction has been established from a study of >22 million IBD patients. With around 1.2% of the USA’s population estimated to have either ulcerative colitis or Crohn’s disease, and 70,000 new cases reported every year, these results will have a significant impact on the monitoring of cardiac health in IBD patients.
Previous studies have indicated a clear association between chronic inflammatory conditions, including rheumatoid arthritis and systemic lupus erythematosus, and heart disease; thus, researchers set out to assess the number of IBD patients who develop heart disease. The 3-year investigation, the results of which were revealed at the 2018 American College of Cardiology (ACC) meeting on 10th–12th March, used the IBM® Explorys database of electronic medical records from 26 healthcare systems across the USA to measure heart disease prevalence, using heart attacks as an indicator.
The researchers, led by Dr Muhammad Panhwar and Dr Mahazarin Ginwalla, University Hospitals Harrington Heart & Vascular Institute, Cleveland, Ohio, USA, noted that 5.9% of patients with IBD experienced heart attacks compared to 3.5% of patients without IBD, equating to an almost two-fold increase in the prevalence of heart disease with IBD. Adjusting for race, sex, age, and traditional heart disease risk factors, such as high blood pressure, diabetes, and smoking, the team concluded that IBD patients had approximately a 23% increased risk of having a heart attack. The highest risk was associated with younger patients (<40 years old), with diagnosis at an earlier age, as well as female sex, being associated with increased levels of inflammation and greater disease aggression.
Considering the large number of IBD patients who may have undiagnosed heart disease, Dr Panhwar concluded: “Our hope is that our study encourages more clinicians to screen these [IBD] patients more aggressively for heart disease.” Dr Ginwalla added: “Clinicians who care for patients with traditional cardiovascular risk factors who also have IBD should recognise IBD as a cardiovascular risk factor as well and treat it appropriately.” The identification of patients at a high risk of cardiac disease, such as young women, will also lead to closer monitoring and screening of these populations.