S1129 Incidence of Cardiovascular Events in Patients With PSC With and Without IBD

Abstract

Introduction: Primary sclerosing cholangitis (PSC) is a disorder characterized by biliary inflammation and fibrosis. PSC patients are often diagnosed with ulcerative colitis (UC) or Crohn’s Disease (CD) during their disease course. Some trials have reported increased rates of cardiovascular (CV) events in patients with inflammatory bowel disease (IBD), but others have not.1,2 Research linking PSC with CV disease is lacking and conflicting.3,4 This study aims to determine and compare the incidence of CV events in PSC patients with and without UC or CD. Methods: Single-center, retrospective cohort study including adult PSC patients with or without IBD between April 2010 and April 2020. Patients with a history of other liver disorders were excluded. Data included demographics, clinical and laboratory records. Incidence of cardiovascular events: STEMI, NSTEMI, CVA and PVD during the study period were collected. Statistical analysis of variables was conducted by T-Test, Chi-square and ANOVA. Logistic regression analysis was used to determine the likelihood of a CV event in PSC patients with and without UC or CD. Results: 283 consecutive patients with PSC were identified, with a mean age of 41 years at diagnosis. 64% of the patients were male, 92% white and 98.2% non-Hispanic. 50% had both PSC and UC, and 20% PSC and CD. The average clinic follow-up was 6.59 years. Patients with PSC alone were more likely to be smokers (32.53% p=0.01). Alcohol consumption, BMI, history of cirrhosis, DM, HTN, HLD or statin and ASA use at the first visit did not differ among the groups. Two patients in each study group experienced a MI (1 STEMI, 1 NSTEMI per group), 13 patients a CVA (5 in the PSC group, 6 in the PSC and UC group, 2 in the PSC and CD group) and 8 patients PVD (3 in the PSC, 4 in the PSC and UC group and 1 in the PSC and CD group) during the study period (see table 1). None of these occurrences was statistically significant. Logistic regression analysis did not show an association between cardiovascular events and the diagnosis of PSC with or without UC or CD. Conclusion: A concomitant diagnosis of IBD in patients with PSC do not confer a statistically significant risk of developing a cardiovascular event.Table 1.: Changes In Lipids Between First And Last Visit Among Patients With PSC Alone And Those With Both PSC and UC or CD. Abbreviations: TG, triglycerides; LDL, low-density lipoproteins; HDL, high-density lipoproteins; PSC, Primary sclerosing cholangitis, UC, Ulcerative Colitis; CD, Crohn’s Disease.