Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota; Division of Gastroenterology, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Clin Gastroenterol Hepatol. 2018 Oct;16(10):1607-1615.e1. doi: 10.1016/j.cgh.2018.04.031. Epub 2018 Apr 24.
BACKGROUND & AIMS: There are conflicting data as to whether inflammatory bowel diseases (IBDs) increase risk for cardiovascular disease. We sought to examine the risk of acute myocardial infarction (AMI) and heart failure in patients with IBD.
We identified patients diagnosed with IBD in Olmsted County, Minnesota, from 1980 through 2010 (n = 736). For each patient, 2 individuals without IBD (controls, n = 1472) were randomly selected, matched for age, sex, and index date of disease diagnosis. Primary outcomes were AMI and heart failure. Cox proportional hazards analysis was used to estimate the risk of AMI and heart failure.
After adjustments for traditional cardiovascular disease risk factors, IBD associated independently with increased risk of AMI (adjusted hazard ratio [aHR], 2.82; 95% CI, 1.98-4.04) and heart failure (aHR, 2.03; 95% CI, 1.36-3.03). The relative risk of AMI was significantly increased in patients with Crohn's disease (aHR vs controls, 2.89; 95% CI, 1.65-5.13) or ulcerative colitis (aHR vs controls, 2.70; 1.69-4.35). The relative risk of AMI was increased among users of systemic corticosteroids (aHR vs controls, 5.08; 95% CI, 3.00-8.81) and nonusers (aHR vs controls, 1.79; 95% CI, 1.08-2.98). The relative risk of heart failure was significantly increased among patients with ulcerative colitis (aHR, 2.06; 95% CI, 1.18-3.65), but not Crohn's disease. The relative risk of heart failure was increased among users of systemic corticosteroids (aHR, 2.51; 95% CI, 1.93-4.57), but not nonusers.
In a population-based cohort study, we found that despite a lower prevalence of traditional risk factors for AMI and heart failure, patients with IBD are at increased risk for these cardiovascular disorders.
关于炎症性肠病（IBD）是否会增加心血管疾病的风险，目前存在相互矛盾的数据。我们旨在研究 IBD 患者发生急性心肌梗死（AMI）和心力衰竭的风险。
我们在明尼苏达州奥姆斯特德县识别了 1980 年至 2010 年间诊断为 IBD 的患者（n=736）。为每位患者选择了 2 名无 IBD 的个体（对照组，n=1472），以年龄、性别和疾病诊断的索引日期相匹配。主要结局为 AMI 和心力衰竭。采用 Cox 比例风险分析来评估 AMI 和心力衰竭的风险。
在调整了传统心血管疾病危险因素后，IBD 与 AMI（调整后的危险比[aHR]，2.82；95%CI，1.98-4.04）和心力衰竭（aHR，2.03；95%CI，1.36-3.03）的发生风险增加独立相关。与对照组相比，克罗恩病（aHR 与对照组相比，2.89；95%CI，1.65-5.13）或溃疡性结肠炎（aHR 与对照组相比，2.70；1.69-4.35）患者的 AMI 相对风险显著增加。全身性皮质类固醇使用者（aHR 与对照组相比，5.08；95%CI，3.00-8.81）和非使用者（aHR 与对照组相比，1.79；95%CI，1.08-2.98）的 AMI 相对风险增加。与对照组相比，溃疡性结肠炎（aHR，2.06；95%CI，1.18-3.65）患者心力衰竭的相对风险显著增加，但克罗恩病患者则不然。全身性皮质类固醇使用者（aHR，2.51；95%CI，1.93-4.57）心力衰竭的相对风险增加，但非使用者则不然。
在一项基于人群的队列研究中，我们发现，尽管 IBD 患者发生 AMI 和心力衰竭的传统危险因素患病率较低，但他们发生这些心血管疾病的风险仍增加。
