Cohen-Heyman Noa, Chodick Gabriel
Department of Epidemiology and Preventive Medicine, School of Public Health, Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 6997801, Israel.
Department of Internal Medicine T, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
Int J Cardiol Cardiovasc Risk Prev. 2025 Jan 4;24:200363. doi: 10.1016/j.ijcrp.2025.200363. eCollection 2025 Mar.
The relationship between inflammatory bowel diseases (IBD) and the risk of ischemic heart diseases (IHD) remains a subject of debate. In this study, we sought to investigate the association between IBD and long-term risk of IHD in a substantial cohort of IBD patients.
In this retrospective cohort study we utilized data from a state-mandated provider in Israel (Maccabi Healthcare Services). We identified all eligible patients diagnosed with IBD between 1/1990 and 7/2021 that were individually matched by sex-and-birth date to 10 MHS members with no indication of IBD. Study population was followed through the data until 12/2021 to examine the occurrence of IHD events.
A total of 14,768 IBD patients (6144 UC, 8624 CD) and 120338 matched non-IBD individuals were eligible for the analysis. Over a mean follow-up of 10.5 years, 285 (1.9 %) of participants with IBD and 1175 (1.0 %) of the reference group experienced our composite outcome, representing an HR of 1.98 (95%CI: 1.74-2.25). When stratified by sex, risk of IHD associated with IBD in males (HR = 1.82; 95 % CI: 1.52-2.17), whereas a negative association was noted among female patients (HR = 0.72; 95%CI: 0.55-0.95). Study results were generally unchanged when analyses were limited to patients with CD, UC, patients on steroids, and patients on immunosuppressants.
Our study reveals a notable excess risk of IHD in male patients with IBD. Further research is needed to better elucidate the mechanisms involved in this relationship.
炎症性肠病（IBD）与缺血性心脏病（IHD）风险之间的关系仍是一个有争议的话题。在本研究中，我们试图在大量IBD患者队列中调查IBD与IHD长期风险之间的关联。
在这项回顾性队列研究中，我们使用了以色列一家国家指定医疗机构（马卡比医疗服务公司）的数据。我们确定了1990年1月至2021年7月期间所有诊断为IBD的符合条件的患者，并按性别和出生日期将其与10名无IBD迹象的马卡比医疗服务公司成员进行个体匹配。通过这些数据对研究人群进行随访，直至2021年12月，以检查IHD事件的发生情况。
共有14768例IBD患者（6144例溃疡性结肠炎、8624例克罗恩病）和120338例匹配的非IBD个体符合分析条件。在平均10.5年的随访中，285例（1.9%）IBD参与者和1175例（1.0%）参照组经历了我们的复合结局，风险比为1.98（95%置信区间：1.74 - 2.25）。按性别分层时，IBD在男性中与IHD相关的风险（风险比 = 1.82；95%置信区间：1.52 - 2.17），而在女性患者中观察到负相关（风险比 = 0.72；95%置信区间：0.55 - 0.95）。当分析仅限于克罗恩病患者、溃疡性结肠炎患者、使用类固醇的患者和使用免疫抑制剂的患者时，研究结果总体上没有变化。
我们的研究揭示了男性IBD患者中IHD存在显著的额外风险。需要进一步研究以更好地阐明这种关系所涉及的机制。
