S1021 Inflammatory Bowel Disease, Subclinical Atherosclerosis, and Cardiovascular Disease: A Case-Control Analysis

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Introduction: Inflammatory Bowel Disease (IBD) is classified with other immune-mediated inflammatory diseases (IMID). Many IMID such as rheumatoid arthritis and systemic lupus erythematosus have been shown to predispose patients to atherosclerotic cardiovascular disease (ASCVD) even without traditional cardiovascular risk factors. An association between IBD and ASCVD has been reported, but is less well-defined. In addition, there is lacking data on risk of subclinical atherosclerosis in patients with IBD. Methods: We performed a case-control analysis of patients seen at a tertiary medical center who underwent coronary calcium scoring (CCS) as part of routine clinical care. Patients IBD were compared to patients without IBD for differences in CCS and development of cardiac events and/or death. Controls were randomly selected from age and sex matched lists of CCS and excluded if they had a prior history of ASCVD. The association of IBD status with time to cardiac events or death was compared using log rank tests, and Cox regression was used to estimate hazard ratios. Subjects were considered at risk from the time of CCS until they had the event of interest or were censored at last contact. Results: A total of 53 IBD case subjects [28 Crohn’s disease (CD); 24 Ulcerative Colitis (UC)] and 106 controls without IBD were included. There were no significant differences between the two groups regarding BMI, race, smoking status, statin use, diabetes, or aspirin use. The was no significant difference in CCS between the two groups (1.1 vs. 0, p = 0.59). Within the IBD population, there was no difference in the CCS between CD and UC (0 for CD and 7.5 for UC; p = 0.48). There was no significant difference in development of cardiac events or death between IBD cases and non-IBD controls (p = 0.37) during follow up. The hazard ratio for a doubling of the CCS and development of cardiac events or death was significant (HR 1.27, 95% CI 1.09-1.49; p = 0.003); however, IBD status was not found to be significant (HR 1.95, 95% CI 0.53-7.12, p =0.3). (Figure) Conclusion: IBD status does not appear to be associated with increased risk of subclinical atherosclerosis as measured by CCS. Elevation in the CCS is associated with risk of cardiac events and death; however, IBD status does not appear to be associated with risk of cardiac events and death. Larger studies are needed to further define the relationship between IBD, subclinical atherosclerosis, and ASCVD. (Table)Figure 1.: Cardiac event-free Survival in IBD cases vs. non-IBD Controls Table 1. - Demographics by IBD case/control status IBD n=53 Non-IBD n=106 P-value Age 55 56 0.97 Female 18 (34%) 34 (32%) 0.81 BMI 28 27 0.99 Race: Caucasian 53 (100% 100 (94%) 0.21 Smoker 14 (26%) 28 (26%) 1 Statin use 22 (42%) 57 (46%) 0.57 Diabetes 5 (9%) 10 (9%) 1 Aspirin Use 9 (17%) 26 (25%) 0.28