P-037 YI Cardiovascular Morbidity in Hospitalized Patients With Inflammatory Bowel Disease Compared to Patients Without Inflammatory Bowel Disease and Other Autoimmune Diseases

Abstract

BACKGROUND: Coronary artery disease (CAD) is common among the general population and individuals with autoimmune disorders such as systemic lupus erythematosus (SLE), and rheumatoid arthritis (RA) due to inflammation that increases the risk of atherosclerosis. The prevalence of cardiovascular morbidity in inflammatory bowel disease in the United States is not well established. We aimed to examine the prevalence of cardiovascular morbidity among hospitalized inflammatory bowel disease (IBD) patients compared with the general hospitalized population and hospitalized RA and SLE patients in the 2011 Nationwide Inpatient Sample (NIS)., METHODS: NIS 2011 contains a 20% stratified sample of all discharges from non-federal acute care hospitals in the United States. Each record in the NIS represents a single hospital discharge and includes patient demographics, hospital characteristics and up to 25 International Classification of Diseases 9th revision, clinical modification (ICD-9-CM) codes. All individuals with information on age and sex aged 18 to 100 with complete coding history were eligible. Hospitalizations with ICD-9-CM codes 555.x (Crohns disease) or 556.x (ulcerative colitis) were considered IBD. Comparisons were made with hospitalizations without diagnosis of IBD (non-IBD), SLE (710.0), and RA (714.0). Cardiovascular morbidity was defined by acute myocardial infarction (410.x) or CAD (411.x, 412.x, 413.x and 414.x) as the primary diagnosis. Odds ratios (OR) comparing the prevalence of acute MI and CAD in IBD compared with non-IBD, SLE and RA were computed adjusting for age, gender, diabetes, hypertension, hyperlipidemia and smoking., RESULTS: A total of 63,387 of 6,683,491 (1.0%) hospitalizations in the database included a diagnosis of IBD with 40,420 CD (63.8%) and 22,967 UC (36.2%) hospitalizations. Median ages for CD, UC and non-IBD patients were 49, 56 and 58 respectively. 57.5% of IBD and 59.2% of non-IBD patients were females. Acute MI was present in 0.5% of CD, 0.9% of UC, 1.8% of non-IBD, 1.2% of SLE and 1.6% of RA hospitalizations. CAD was present in 1.2% of CD, 1.8% of UC 3.8% of non-IBD, 2.5% of SLE and 3.2% of RA hospitalizations. The odds of acute MI was lower in CD (OR 0.50; 95% CI, 0.45-0.56) and UC (OR 0.68; 95% CI, 0.61-0.76) compared with the non-IBD hospitalizations. The odds of CAD was lower in CD (OR 0.45; 95% CI, 0.41-0.49) and UC (OR 0.54; 95% CI, 0.43-0.60) compared with the non-IBD hospitalizations. Acute MI was also less common in IBD patients than in SLE (OR 0.55; 95% CI, 0.51-0.61) and RA (OR 0.63; 95% CI, 0.56-0.73) with the same trend for the CAD comparisons (P < 0.05)., CONCLUSIONS: The prevalence of MI and CAD during hospitalization was lower in IBD than in the general population and other autoimmune diseases. This suggests that IBD patients are unique among the autoimmune diseases. Compared with other autoimmune diseases, IBD patients may not need to be screened more aggressively for cardiovascular disease but should undergo routine screening per general population guidelines., (C) Crohn's & Colitis Foundation of America, Inc.