Ebrahimi Ramin, Ebrahimi Fahim, Niess Jan Hendrik, Mahdi Ali, Chen Shaojie, Di Vece Davide, Bian Weiwei, Kutz Alexander, Forss Anders
Division of Cardiology, Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Aliment Pharmacol Ther. 2025 Jun;61(12):1904-1912. doi: 10.1111/apt.70162. Epub 2025 Apr 29.
Inflammatory bowel diseases (IBD) have been associated with an increased long-term risk of coronary artery disease due to chronic systemic inflammation.
To evaluate the risk of major adverse cardiovascular events (MACE) after coronary interventions.
In this nationwide cohort study of adults undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) (2012-2022), patients with IBD were propensity score-matched 1:10 to comparators without IBD. The primary outcome was MACE, a composite of acute myocardial infarction, stroke, hospitalisation for heart failure, or mortality. Secondary outcomes included each MACE component, 30-day all-cause readmission, revascularisation and in-hospital outcomes including intensive care unit admission and length of hospital stay. We calculated hazard ratios (HRs) and incidence rates (IRs) using Cox proportional hazards modelling.
We included 987 patients with IBD and 9571 matched comparators. After a median follow-up of 3.5 years, MACE occurred in 488 patients with IBD (49.4%, IR: 96.5/10,000 person-years [PY]) and in 3857 matched comparators (40.3%, IR: 68.9/10,000 PY); HR 1.37 (95% CI, 1.24-1.52). This equates to one additional MACE for every 36 patients with IBD over 10 years. The risk of each MACE component was increased, except for stroke. There were no differences between IBD subtypes or coronary intervention (PCI vs. CABG). Risks were highest in older individuals and elective interventions.
Patients with IBD were at 37% higher risk of MACE after coronary intervention, indicating a need for intensified cardiovascular risk reduction in these high-risk individuals.
由于慢性全身性炎症，炎症性肠病（IBD）与冠状动脉疾病的长期风险增加有关。
评估冠状动脉介入治疗后主要不良心血管事件（MACE）的风险。
在这项针对接受经皮冠状动脉介入治疗（PCI）或冠状动脉旁路移植术（CABG）的成年人的全国性队列研究（2012 - 2022年）中，将IBD患者与无IBD的对照者按倾向得分1:10进行匹配。主要结局是MACE，即急性心肌梗死、中风、因心力衰竭住院或死亡的综合指标。次要结局包括每个MACE组分、30天全因再入院、血运重建以及住院结局，包括重症监护病房入住情况和住院时间。我们使用Cox比例风险模型计算风险比（HRs）和发病率（IRs）。
我们纳入了987例IBD患者和9571例匹配的对照者。中位随访3.5年后，488例IBD患者（49.4%，IR：96.5/10,000人年[PY]）和3857例匹配的对照者（40.3%，IR：68.9/10,000 PY）发生了MACE；HR为1.37（95%CI，1.24 - 1.52）。这相当于每36例IBD患者在10年内会多发生1例MACE。除中风外，每个MACE组分的风险均增加。IBD亚型或冠状动脉介入治疗（PCI与CABG）之间无差异。风险在老年个体和择期干预中最高。
IBD患者冠状动脉介入治疗后发生MACE的风险高37%，表明这些高危个体需要强化心血管风险降低措施。
