Abstract 16584: Inflammatory Bowel Disease is Independently Associated With Elevated Coronary Artery Calcium Score in Young Patients: Insights From CLARIFY Study

Abstract

Introduction: Chronic inflammatory disease states are associated with higher incidence of premature atherosclerotic cardiovascular disease (ASCVD) in the young. However, data on whether younger patients with inflammatory bowel disease (IBD) are particularly at higher risk for subclinical atherosclerotic disease is scarce. Methods: Using data obtained from the CLARIFY registry (Clinicaltrials.gov NCT04075162), a prospective study of no-charge coronary artery calcium (CAC) testing at University Hospitals, we identified all patients with ulcerative colitis or Crohn’s disease and compared the presence (>0) and high (≥100) CAC with all patients in CLARIFY without IBD stratified by age group (non-elderly: ≤65 years; elderly >65 years), and adjusting for traditional ASCVD risk factors. Results: A total of 475 patients with IBD (252 UC, 196 CD, 27 both) and 43,437 controls without IBD were included. Compared with control, patients with IBD were more likely to be female (59% vs 50%, P<0.001), to have diabetes (12% vs 17%, P<0.001), and to be smokers (38% vs 22%, P<0.001). Overall, 31% of adults with IBD had CAC>100 compared to 28% without IBD (p=0.10). The respective prevalence was 25% vs. 21% (p=0.08) among non-elderly participants, and 45% vs. 47% (p=0.49) among elderly. In the total population, no association between IBD and CAC>0 or CAC>100 was noted. However, there was evidence of effect modification by pre-specified age strata (p-value for interaction 0.012, figure), where the odds of CAC≥100 was 1.38-fold higher (95% CI: 1.02-1.89) for IBD among participants ≤65 years vs among elderly participants [OR 0.84, 95% CI: 0.57-1.22]. Conclusions: Non-elderly IBD patients are at increased risk for significant coronary calcified atherosclerotic disease. Further studies are needed to understand underlying biological processes and implications of increased atherosclerotic disease risk among young adults with IBD.