Prognosis After First-Time Myocardial Infarction in Patients With Inflammatory Bowel Disease According to Disease Activity: Nationwide Cohort Study
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Prognosis After First-Time Myocardial Infarction in Patients With Inflammatory Bowel Disease According to Disease Activity : Nationwide Cohort Study. / Kristensen, Søren Lund; Ahlehoff, Ole; Lindhardsen, Jesper; Erichsen, Rune; Lamberts, Morten; Khalid, Usman; Nielsen, Ole Haagen; Torp-Pedersen, Christian; Gislason, Gunnar Hilmar; Hansen, Peter Riis.
In: Circulation. Cardiovascular Quality and Outcomes (Print), Vol. 7, No. 6, 11.2014, p. 857-862.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Prognosis After First-Time Myocardial Infarction in Patients With Inflammatory Bowel Disease According to Disease Activity
T2 - Nationwide Cohort Study
AU - Kristensen, Søren Lund
AU - Ahlehoff, Ole
AU - Lindhardsen, Jesper
AU - Erichsen, Rune
AU - Lamberts, Morten
AU - Khalid, Usman
AU - Nielsen, Ole Haagen
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar Hilmar
AU - Hansen, Peter Riis
N1 - © 2014 American Heart Association, Inc.
PY - 2014/11
Y1 - 2014/11
N2 - BACKGROUND: Inflammatory bowel disease (IBD) is associated with increased cardiovascular risk. We examined the effect of active IBD on major adverse cardiovascular outcomes after myocardial infarction (MI).METHODS AND RESULTS: In nationwide registries, we identified 86 790 patients with first-time MI from the period 2002 to 2011. A total of 1030 patients had IBD, and we categorized their disease activity stages into either flare (120 days), persistent (>120 days) activity, or remission. Short-term mortality was estimated in a logistic regression-model, whereas risk of recurrent MI, all-cause mortality, and a composite of recurrent MI, cardiovascular death, and stroke were estimated by Cox regression-models. Odds ratio of death during hospitalization or within 30 days of discharge (n=13 339) corresponded to 3.29 (95% confidence interval [CI], 1.98-5.45) for patients in IBD flares, 1.62 (95% CI, 0.95-2.77) for persistent activity, and 0.97 (95% CI, 0.78-1.19) for remission when compared with the non-IBD group. Among 73 451 patients, including 863 with IBD, alive 30 days after discharge, IBD was associated with hazard ratios of 1.21 (95% CI, 0.99-1.49) for recurrent MI, 1.14 (95% CI, 1.01-1.28) for all-cause mortality, and 1.17 (95% CI, 1.03-1.34) for the composite end point. When compared with the non-IBD group, IBD flares, in particular, were associated with increased risks of recurrent MI (hazard ratio, 3.09; 95% CI, 1.79-5.32), all-cause mortality (hazard ratio, 2.25; 95% CI, 1.61-3.15), and the composite end point (hazard ratio, 2.04; 95% CI, 1.35-3.06), whereas no increased risk was identified in remission.CONCLUSIONS: Active inflammatory bowel disease worsens prognosis after MI, in particular, in relation with flares.
AB - BACKGROUND: Inflammatory bowel disease (IBD) is associated with increased cardiovascular risk. We examined the effect of active IBD on major adverse cardiovascular outcomes after myocardial infarction (MI).METHODS AND RESULTS: In nationwide registries, we identified 86 790 patients with first-time MI from the period 2002 to 2011. A total of 1030 patients had IBD, and we categorized their disease activity stages into either flare (120 days), persistent (>120 days) activity, or remission. Short-term mortality was estimated in a logistic regression-model, whereas risk of recurrent MI, all-cause mortality, and a composite of recurrent MI, cardiovascular death, and stroke were estimated by Cox regression-models. Odds ratio of death during hospitalization or within 30 days of discharge (n=13 339) corresponded to 3.29 (95% confidence interval [CI], 1.98-5.45) for patients in IBD flares, 1.62 (95% CI, 0.95-2.77) for persistent activity, and 0.97 (95% CI, 0.78-1.19) for remission when compared with the non-IBD group. Among 73 451 patients, including 863 with IBD, alive 30 days after discharge, IBD was associated with hazard ratios of 1.21 (95% CI, 0.99-1.49) for recurrent MI, 1.14 (95% CI, 1.01-1.28) for all-cause mortality, and 1.17 (95% CI, 1.03-1.34) for the composite end point. When compared with the non-IBD group, IBD flares, in particular, were associated with increased risks of recurrent MI (hazard ratio, 3.09; 95% CI, 1.79-5.32), all-cause mortality (hazard ratio, 2.25; 95% CI, 1.61-3.15), and the composite end point (hazard ratio, 2.04; 95% CI, 1.35-3.06), whereas no increased risk was identified in remission.CONCLUSIONS: Active inflammatory bowel disease worsens prognosis after MI, in particular, in relation with flares.
U2 - 10.1161/CIRCOUTCOMES.114.000918
DO - 10.1161/CIRCOUTCOMES.114.000918
M3 - Journal article
C2 - 25316773
VL - 7
SP - 857
EP - 862
JO - Circulation: Cardiovascular Quality and Outcomes
JF - Circulation: Cardiovascular Quality and Outcomes
SN - 1941-7713
IS - 6
ER -
ID: 137324768