Premature Atherosclerotic Cardiovascular Disease Risk Among Patients with Inflammatory Bowel Disease. Am J Med 2021 Aug;134(8):1047-1051.e2
Date
04/05/2021Pubmed ID
33812865DOI
10.1016/j.amjmed.2021.02.029Scopus ID
2-s2.0-85105361864 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
BACKGROUND: Recent literature has shown an association between atherosclerotic cardiovascular disease and inflammatory bowel disease, potentially mediated through chronic inflammatory pathways. However, there is a paucity of data demonstrating this relationship among young patients with premature atherosclerotic cardiovascular disease.
METHODS: Using data from the nationwide Veterans wIth premaTure AtheroscLerosis (VITAL) registry, we assessed the association between extremely premature and premature atherosclerotic cardiovascular disease (age at diagnosis: ≤40 years and ≤55 years, respectively) and inflammatory bowel disease. Patients were compared with age-matched controls without atherosclerotic cardiovascular disease. Multivariable regression models adjusted for traditional risk factors.
RESULTS: We identified 147,600 patients and 9485 patients with premature and extremely premature atherosclerotic cardiovascular disease, respectively. Compared with controls, there was a higher prevalence of overall inflammatory bowel disease among premature (0.96% vs 0.84%; odds ratio [OR] 1.14; 95% confidence interval [CI], 1.08-1.21) and extremely premature (1.36% vs 0.75%; OR 1.82; 95% CI, 1.52-2.17) patients. After adjustment, these associations attenuated in both premature and extremely premature groups (OR 1.07; 95% CI, 1.00-1.14 and OR 1.61; 95% CI, 1.34-1.94, respectively).
CONCLUSION: Inflammatory bowel disease is associated with higher odds of extremely premature atherosclerotic cardiovascular disease, especially for those age ≤40 years. With increasing age, this risk is attenuated by traditional cardiometabolic factors such as obesity, hypertension, diabetes, smoking, and dyslipidemia. Prospective studies are needed to assess the role of early intervention to decrease cardiovascular risk among young patients with inflammatory bowel disease.
Author List
Lee MT, Mahtta D, Chen L, Hussain A, Al Rifai M, Sinh P, Khalid U, Nasir K, Ballantyne CM, Petersen LA, Virani SSAuthor
Preetika Sinh MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAge Factors
Atherosclerosis
Cardiovascular Diseases
Cohort Studies
Female
Humans
Inflammatory Bowel Diseases
Male
Middle Aged
Retrospective Studies
Risk Assessment
