Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.

<h4>Purpose</h4>Chronic inflammatory diseases have been linked to increased risk of atherothrombotic events, but the risk associated with inflammatory bowel disease (IBD) is unclear. We therefore examined the risk of myocardial infarction (MI), stroke, and cardiovascular death in patient...

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Autores principales:	Søren Lund Kristensen, Ole Ahlehoff, Jesper Lindhardsen, Rune Erichsen, Gunnar Vagn Jensen, Christian Torp-Pedersen, Ole Haagen Nielsen, Gunnar Hilmar Gislason, Peter Riis Hansen
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dcb80556880647b3bd8faf0095ce55a9
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spelling	oai:doaj.org-article:dcb80556880647b3bd8faf0095ce55a92021-11-18T07:57:15ZDisease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.1932-620310.1371/journal.pone.0056944https://doaj.org/article/dcb80556880647b3bd8faf0095ce55a92013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23457642/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Purpose</h4>Chronic inflammatory diseases have been linked to increased risk of atherothrombotic events, but the risk associated with inflammatory bowel disease (IBD) is unclear. We therefore examined the risk of myocardial infarction (MI), stroke, and cardiovascular death in patients with IBD.<h4>Methods</h4>In a nationwide Danish population-based setting, a cohort of patients with incident IBD between 1996 and 2009 were identified in national registers. Hospitalizations with IBD as primary diagnosis, initiation of biological treatment and dispensed prescriptions of corticosteroids were all used as surrogate markers for disease activity, with flares classified as the first 120 days after diagnosis of IBD, and 120 days after a new corticosteroid prescription, biological treatment or IBD hospitalization, respectively. Continued corticosteroid prescriptions or IBD hospitalizations were defined as persistent activity, and periods free of such events were defined as remissions. Poisson regression was used to examine risk of MI, stroke, and cardiovascular death using a matched population-based comparison cohort as reference.<h4>Results</h4>We identified 20,795 IBD patients with a mean age of 40.3 years that were matched according to age and sex with 199,978 controls. During the study period, there were 365 patients with MI, 454 with stroke, and 778 with cardiovascular death. Patients with IBD had an overall increased risk of MI (rate ratio [RR] 1.17 [95% confidence interval 1.05-1.31]), stroke (RR 1.15 [1.04-1.27], and cardiovascular death (RR 1.35 [1.25-1.45]). During flares and persistent IBD activity the RRs of MI increased to 1.49 (1.16-1.93) and 2.05 (1.58-2.65), the RRs of stroke to 1.53 (1.22-1.92) and 1.55 (1.18-2.04) and for cardiovascular death 2.32 (2.01-2.68) and 2.50 (2.14-2.92). In remission periods, the risk of MI, stroke and cardiovascular death was similar to controls.<h4>Conclusion</h4>Inflammatory bowel disease is associated with increased risk of MI, stroke, and cardiovascular death during periods with active disease.Søren Lund KristensenOle AhlehoffJesper LindhardsenRune ErichsenGunnar Vagn JensenChristian Torp-PedersenOle Haagen NielsenGunnar Hilmar GislasonPeter Riis HansenPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e56944 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Søren Lund Kristensen Ole Ahlehoff Jesper Lindhardsen Rune Erichsen Gunnar Vagn Jensen Christian Torp-Pedersen Ole Haagen Nielsen Gunnar Hilmar Gislason Peter Riis Hansen Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.
description	<h4>Purpose</h4>Chronic inflammatory diseases have been linked to increased risk of atherothrombotic events, but the risk associated with inflammatory bowel disease (IBD) is unclear. We therefore examined the risk of myocardial infarction (MI), stroke, and cardiovascular death in patients with IBD.<h4>Methods</h4>In a nationwide Danish population-based setting, a cohort of patients with incident IBD between 1996 and 2009 were identified in national registers. Hospitalizations with IBD as primary diagnosis, initiation of biological treatment and dispensed prescriptions of corticosteroids were all used as surrogate markers for disease activity, with flares classified as the first 120 days after diagnosis of IBD, and 120 days after a new corticosteroid prescription, biological treatment or IBD hospitalization, respectively. Continued corticosteroid prescriptions or IBD hospitalizations were defined as persistent activity, and periods free of such events were defined as remissions. Poisson regression was used to examine risk of MI, stroke, and cardiovascular death using a matched population-based comparison cohort as reference.<h4>Results</h4>We identified 20,795 IBD patients with a mean age of 40.3 years that were matched according to age and sex with 199,978 controls. During the study period, there were 365 patients with MI, 454 with stroke, and 778 with cardiovascular death. Patients with IBD had an overall increased risk of MI (rate ratio [RR] 1.17 [95% confidence interval 1.05-1.31]), stroke (RR 1.15 [1.04-1.27], and cardiovascular death (RR 1.35 [1.25-1.45]). During flares and persistent IBD activity the RRs of MI increased to 1.49 (1.16-1.93) and 2.05 (1.58-2.65), the RRs of stroke to 1.53 (1.22-1.92) and 1.55 (1.18-2.04) and for cardiovascular death 2.32 (2.01-2.68) and 2.50 (2.14-2.92). In remission periods, the risk of MI, stroke and cardiovascular death was similar to controls.<h4>Conclusion</h4>Inflammatory bowel disease is associated with increased risk of MI, stroke, and cardiovascular death during periods with active disease.
format	article
author	Søren Lund Kristensen Ole Ahlehoff Jesper Lindhardsen Rune Erichsen Gunnar Vagn Jensen Christian Torp-Pedersen Ole Haagen Nielsen Gunnar Hilmar Gislason Peter Riis Hansen
author_facet	Søren Lund Kristensen Ole Ahlehoff Jesper Lindhardsen Rune Erichsen Gunnar Vagn Jensen Christian Torp-Pedersen Ole Haagen Nielsen Gunnar Hilmar Gislason Peter Riis Hansen
author_sort	Søren Lund Kristensen
title	Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.
title_short	Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.
title_full	Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.
title_fullStr	Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.
title_full_unstemmed	Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.
title_sort	disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a danish nationwide cohort study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/dcb80556880647b3bd8faf0095ce55a9
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Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death--a Danish nationwide cohort study.

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