IBD: meta-analysis reveals higher risk for CVD, but not mortality

  • Sun HH & al.
  • Eur J Prev Cardiol
  • 3 Aug 2018

  • curated by Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • IBD is associated with 12%-25% higher risk for cardiovascular disease (CVD) incidence, especially in women.
  • IBD is not associated with excess risk for CVD mortality.

Why this matters

  • The association between IBD and CVD incidence may be driven by inflammation-induced atherogenesis.
  • Patients with IBD should be screened for CVD.

Study design

  • Meta-analysis of 27 studies (n=11 studies of CVD incidence; 16 studies of CVD mortality) that met eligibility criteria after search of PubMed and Web of Knowledge.
  • Funding: None.

Key results

  • IBD was associated with higher incidence across 3 CVD outcomes:
    • Cerebrovascular disease (CVA): pooled relative risk (RR), 1.25 (95% CI, 1.08-1.44);
    • Coronary heart disease (CHD): pooled RR, 1.17 (95% CI, 1.07-1.27); and
    • Myocardial infarction: pooled RR, 1.12 (95% CI, 1.05-1.21).
  • IBD in women was associated with higher CVD incidence than men:
    • CVA in women (pooled RR, 1.77; 95% CI, 1.20-2.59) higher than men (pooled RR, 1.34; 95% CI, 1.11-1.61); and
    • CHD in women (pooled RR, 1.27; 95% CI, 1.12-1.45) higher than men (pooled RR, 1.13; 95% CI, 1.09-1.17).
  • IBD was not associated with higher CVD mortality in Crohn's disease (standardized mortality ratio [SMR], 1.01; 95% CI, 0.90-1.14) or ulcerative colitis (SMR, 0.93; 95% CI, 0.86-1.01).

Limitations

  • Potential residual confounding.

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