Risks of Cardiovascular Events in Patients with Inflammatory Bowel Disease in China: A Retrospective Multicenter Cohort Study

Author:

Fang Leilei1,Gao Han1,Gao Xiang1,Wu Wei1,Miao Yinglei2,Zhang Hongjie3,Guleng Bayasi4,Zhang Hu5ORCID,Wang Yufang5,Li Mingsong6,Yang Hong7,Gao Xiang8,Liang Jie9,Cao Qian10,Shen Jun11,Ran Zhihua11,Wu Kaichun9,Qian Jiaming7,Chen Minhu12,Liu Zhanju1ORCID,

Affiliation:

1. Center for Inflammatory Bowel Disease Research, The Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China

2. Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China

3. Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province 210029, China

4. Department of Gastroenterology, Zhongshan Hospital affiliated with Xiamen University, Xiamen, Fujian Province 361004, China

5. Department of Gastroenterology & Center for Inflammatory Bowel Disease, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, China

6. Department of Gastroenterology, The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province 510150, China

7. Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100006, China

8. Department of Gastroenterology, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province 510655, China

9. State Key Laboratory of Cancer Biology, National Clinical Research Center for Digestive Diseases and Xijing Hospital of Digestive Diseases, The Air Force Military Medical University, Xi'an, Shanxi Province 710032, China

10. Department of Gastroenterology, Sir Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province 310020, China

11. Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Shanghai Inflammatory Bowel Disease Research Center, Renji Hospital, School of Medicine, Shanghai Jiao-Tong University, Shanghai Institute of Digestive Disease, Shanghai 200001, China

12. Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province 510080, China

Abstract

Abstract Background Inflammatory bowel disease (IBD) is a complex chronic disorder characterized by systemic inflammation, which may cause abnormal state of coagulation, resulting in cardiac events. This study aimed to investigate the incidences and risks of cardiac events in patients with IBD in China. Methods A retrospective cohort study was performed comprising 1,435 patients with IBD from 12 IBD centers in China. Cases were matched with 1,588 eligible participants without IBD from 12 medical centers according to age, sex, and laboratory parameters. Results Patients with IBD in China exhibited significantly higher incidences of ischemic heart disease (IHD) (coronary heart disease included) but lower frequencies of right bundle branch block and premature contraction than those of matched controls. The risk of IHD increased in patients with IBD, peaking at the age of 18−35 years. Female patients with IBD were more likely to experience IHD than male patients. C-reactive protein (CRP) levels and neutrophil count in the peripheral blood were positively related with the risk of IHD among patients with Crohn’s disease (CD), whereas plasma fibrinogen levels were negatively related with the risk of IHD both in patients with CD and UC. Conclusions The risk of IHD is increased in patients with IBD, especially in young female patients with IBD when compared to matched non-IBD subjects. CRP and plasma fibrinogen levels and neutrophil count in the peripheral blood may be potential predictors associated with the occurrence of IHD in patients with IBD. The study’s findings have significant implications for the management and prevention of cardiac events in patients with IBD.

Publisher

Oxford University Press (OUP)

Subject

Gastroenterology,Immunology and Allergy

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