Inflammatory bowel disease is associated with an increased risk of cardiovascular events in a sex and age-dependent manner: A historical cohort study

Background

The relationship between inflammatory bowel diseases (IBD) and the risk of ischemic heart diseases (IHD) remains a subject of debate. In this study, we sought to investigate the association between IBD and long-term risk of IHD in a substantial cohort of IBD patients.

Methods

In this retrospective cohort study we utilized data from a state-mandated provider in Israel (Maccabi Healthcare Services). We identified all eligible patients diagnosed with IBD between 1/1990 and 7/2021 that were individually matched by sex-and-birth date to 10 MHS members with no indication of IBD. Study population was followed through the data until 12/2021 to examine the occurrence of IHD events.

Results

A total of 14,768 IBD patients (6144 UC, 8624 CD) and 120338 matched non-IBD individuals were eligible for the analysis. Over a mean follow-up of 10.5 years, 285 (1.9 %) of participants with IBD and 1175 (1.0 %) of the reference group experienced our composite outcome, representing an HR of 1.98 (95%CI: 1.74–2.25). When stratified by sex, risk of IHD associated with IBD in males (HR = 1.82; 95 % CI: 1.52–2.17), whereas a negative association was noted among female patients (HR = 0.72; 95%CI: 0.55–0.95). Study results were generally unchanged when analyses were limited to patients with CD, UC, patients on steroids, and patients on immunosuppressants.

Conclusions

Our study reveals a notable excess risk of IHD in male patients with IBD. Further research is needed to better elucidate the mechanisms involved in this relationship.