Key result
Inflammatory bowel disease was associated with an increased risk of acute coronary syndrome compared to non-IBD controls (adjusted HR 1.23; 95% CI 1.08-1.41).
Why the study?
Systemic inflammation is a recognized mechanism for acute arterial thrombotic events, but data on the risk of ACS in patients with inflammatory bowel disease remain conflicting.
Does inflammatory bowel disease increase the risk of acute coronary syndrome compared to non-IBD controls?
Meta-Analysis (n=225,248)
Does inflammatory bowel disease increase the risk of acute coronary syndrome compared to non-IBD controls?
Hazard Ratio: 1.23 (95% CI 1.08–1.41)
Patients with inflammatory bowel disease have an independently increased risk of acute coronary syndrome, particularly those under 40 years of age.
Objectives Systemic inflammation is increasingly being recognised as a possible mechanism for acute arterial thrombotic events, including acute coronary syndrome (ACS). Despite this, there is conflicting data on the risk of ACS in patients with inflammatory bowel disease (IBD). We performed a contemporary systematic review and meta-analysis to identify the risk of ACS in patients with IBD. Methods PubMed, MEDLINE, EMBASE, CENTRAL and Web of Science were searched up to 27 October 2022. Multivariable-adjusted or propensity matched studies with a non-IBD control cohort were included. HRs were pooled using a random-effects model. Subgroup and sensitivity analyses were conducted in order to explore sources of heterogeneity. Results Twelve retrospective cohort studies were included (225 248 IBD patients). Patients with IBD were associated with an increased risk of ACS in both adjusted (HR 1.23; 95% CI 1.08 to 1.41) and unadjusted analyses (HR 1.50; 95% CI 1.16 to 1.92). Substantial heterogeneity was observed (i 2 =88, p=0.002 and i 2 =98%, p=0.002, respectively). Subgroup analysis of age revealed a greater association of ACS in IBD patients <40 years of age (relative HR 1.50; 95 CI 1.15 to 1.96). Conclusion Patients with IBD demonstrated an independently increased risk of ACS. Prospective studies are required to explore the relationship with disease activity and duration, concomitant medication use and angiographic characteristics and outcomes. PROSPERO registration number CRD42022367846.
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Zaka et al. (2023) conducted a meta-analysis in Inflammatory bowel disease (n=225,248). Inflammatory bowel disease vs. Non-IBD control cohort was evaluated on Acute coronary syndrome (HR 1.23, 95% CI 1.08 to 1.41). Inflammatory bowel disease was associated with an increased risk of acute coronary syndrome compared to non-IBD controls (adjusted HR 1.23; 95% CI 1.08-1.41).
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