Conventional risk factors and cardiovascular outcomes of patients with inflammatory bowel disease with confirmed coronary artery disease

Abstract

Background: Inflammation is increasingly being recognized as an important factor in the pathogenesis of atherosclerosis and outcome of percutaneous coronary intervention (PCI). The purpose of this study was to compare conventional risk factors and PCI outcomes in patients with inflammatory bowel disease (IBD) and non-IBD controls with angiographically proven coronary artery disease (CAD). Methods: We performed a historical cohort study of patients with IBD who were diagnosed with CAD by cardiac catheterization between January 2004 and June 2010. Four non-IBD controls with CAD were matched to each IBD case. Framingham risk score and corresponding 10-year coronary heart disease risk were calculated for all the patients. Outcomes were obtained using a prospectively maintained Institutional Interventional Catheterization Database. Results: One hundred thirty-one patients with IBD (54 Crohn's disease, 77 ulcerative colitis) with CAD and 524 matched non-IBD controls with CAD were included. Patients with IBD were younger (65.3 ± 10.0 versus 67.8 ± 11.0 yr, P = 0.016), had lower prevalence of active tobacco use (10.7% versus 18.7%, P = 0.03), and had lower body mass index (28.0 ± 5.1 versus 29.4 ± 6.4, P = 0.026) compared with controls. Patients with IBD had lower rates of severe left anterior descending artery disease (56% versus 73%, P < 0.0002) and multivessel CAD (71% versus 79%, P = 0.05). There was no difference in post-PCI major adverse cardiovascular outcomes (defined as all-cause death, myocardial infarction, cerebrovascular events, and target lesion revascularization). Conclusions: Patients with IBD are diagnosed with CAD at a younger age as compared with non-IBD patients, are less likely to be active smokers and have lower body mass index. Post-PCI outcomes in patients with IBD with CAD are similar to non-IBD controls with CAD.