Coronary Artery Disease and Inflammatory Bowel Disease

Abstract

Introduction: Chronic inflammatory diseases are linked to accelerated Atherosclerosis, resulting in higher cardiovascular disease prevalence in these patients. The Data on the Inflammatory Bowel Disease (IBD) patients with Cardiovascular diseases is varying. Methods: We selected the National Inpatient Database(NIS) for the year 2013 to select patients. we selected the IBD patients and Age, Gender and Race matched controls from the NIS data. Controls were selected by Propensity score method. our goal was to assess the incidence of the Acute coronary syndrome(ACS) in IBD patients in comparison to the matched controls. Two-way ÷2 analyses were performed to compare the ACS prevalence among the subgroups. In addition, logistic regression was also performed to assess other associated factors with ACS. Results: 59625 IBD patients and 56024 matched controls were selected. In IBD group, 21824(36.67) were UC and 37761(63.3) were Crohn's patients. Mean age was 52.36 and 52.47 in IBD and controls group respectively(P=0.304). Males were 43.4% in IBD group and 43.3% in Control group. females were 56.7% and 56.6% in IBD and control group respectively. white race was 81.7% in both the groups. During the one year period, IBD group had lower ACS admissions than the control group, 1.5% vs 2.7%, OR 0.553,95%CI of 0.509 to 0.601, P < 0.001. Within the IBD group, Ulcerative Colitis patients had more ACS admission than the Crohns Group, 1.9% vs 1.3% with (OR 1.5,95% CI 1.33 to 1.77, P < 0.05). However, when adjusted for age, Race, UC is not associated with higher ACS admissions on Logistic regression. IBD group has lower all-cause mortality than the control group, 1.7% vs 1.8%, with no statistical significance. ACS related mortality is high in IBD (10%) compared to Control group(7.7%) with OR of 1.45, 95%CI 1.098 to 1.958, P=0.013. on Logistic regression, IBD is associated with higher ACS related mortality even after adjusting for comorbidities using the Deyo Modified Charleson index, HTN, obesity. Within the IBD group,UC with higher mortality (12.1%) vs 8.2% in Crohn's but with no stasticial significance Diabetes, HTN, Obesity, Peripheral Vascular Diseases, Cerebrovascular diseases tend to be seen more often in the control and UC groups. Conclusion: IBD is not associated with accelerated Atherosclerosis leading higher ACS incidence but with higher ACS related mortality.