Narous Mariam, Nugent Zoann, Rabinovich-Nikitin Inna, Kirshenbaum Lorrie, Bernstein Charles N
University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada.
University of Manitoba Faculty of Health Sciences, Winnipeg, Manitoba, Canada
BMJ Open. 2025 Mar 21;15(3):e097687. doi: 10.1136/bmjopen-2024-097687.
We aimed to characterise the association between inflammatory bowel disease (IBD) and IBD medications and risk of cardiac arrhythmia.
DESIGN, SETTING AND PARTICIPANTS: In a retrospective population-based study using the University of Manitoba IBD Epidemiology Database (Manitoba, Canada) from 1984 to 2018, we identified 10 992 IBD cases and 102 875 matched controls.
Arrhythmia risk in IBD was adjusted for the presence of comorbidities of the Charlson Comorbidity Index. The effect of IBD medications on the development of arrhythmia was assessed in a nested cohort study of individuals with IBD. Cases were censored at the date of first database identification of a diagnosis of heart failure or myocardial infarction.
The cohort was 48.5% Crohn's disease and 51.5% ulcerative colitis, and 80.5% were incident cases. The median age of incident cases at IBD diagnosis was 35 (IQR, 25 to 49). The median age at arrhythmia diagnosis for persons with IBD was 69 years (IQR, 59 to 77) and for controls 69 years (IQR, 59 to 78). Persons diagnosed with IBD were more likely than controls (HR 1.51; 95% CI, 1.30 to 1.76) to develop arrhythmia. Persons within their sixth decade or younger had increased risk of arrhythmia. When controlling for comorbidities, the significant association between IBD and arrhythmia remains. Medications including 5-aminosalicylates, thiopurines and tumour necrosis factor-α inhibitors were not associated with arrhythmia.
Persons with IBD have a higher risk of arrhythmia prior to a diagnosis with heart disease. Use of IBD medications was not associated with risk of arrhythmia.
我们旨在描述炎症性肠病（IBD）及IBD药物与心律失常风险之间的关联。
设计、背景与参与者：在一项基于人群的回顾性研究中，我们使用了1984年至2018年加拿大曼尼托巴大学IBD流行病学数据库（加拿大曼尼托巴省），确定了10992例IBD病例和102875例匹配对照。
IBD患者的心律失常风险根据查尔森合并症指数的合并症情况进行了调整。在一项针对IBD患者的巢式队列研究中评估了IBD药物对心律失常发生的影响。病例在首次数据库确诊心力衰竭或心肌梗死之日进行截尾。
该队列中48.5%为克罗恩病，51.5%为溃疡性结肠炎，80.5%为新发病例。IBD诊断时新发病例的中位年龄为35岁（四分位间距，25至49岁）。IBD患者心律失常诊断时的中位年龄为69岁（四分位间距，59至77岁），对照为69岁（四分位间距，59至78岁）。被诊断为IBD的人比对照更易发生心律失常（风险比1.51；95%置信区间，1.30至1.76）。60岁及以下的人发生心律失常的风险增加。在控制合并症时，IBD与心律失常之间的显著关联仍然存在。包括5-氨基水杨酸、硫唑嘌呤和肿瘤坏死因子-α抑制剂在内的药物与心律失常无关。
IBD患者在被诊断患有心脏病之前发生心律失常的风险更高。使用IBD药物与心律失常风险无关。
