Ischaemic heart disease

IBD an independent risk factor for MI


Patients with IBD have an increased risk of heart attack compared to the general population, possibly due to an effect of the chronic inflammation associated with the disease.

US research has shown that myocardial infarction rates are about twice as high in people with IBD, compared to the general population, and rates are particularly high among IBD young patients.

The findings come from a review of medical records for 211,870 patients with a diagnosis of IBD, for whom rates of cardiovascular events were compared to people without IBD

The analysis found that the risk of MI was 3.9% in IBD patients and 1.65% in controls (relative risk [RR] 2.4). The increase in heart attack risk was highest among younger patients age 20-25, for whom the relative risk was 20.5. Excess risk decreased with age, with a relative risk of 1.81 for IBD patients aged 60-64.

People with IBD were also more likely to have cardiovascular risk factors such as diabetes, hypertension, dyslipidaemia and smoking compared to people without IBD.

Presenting the findings at the American College of Cardiology meeting in Orlando, Dr Panhwar noted that IBD was usually diagnosed between the ages of 15 and 30 years old, and younger patients and females with the condition had more aggressive and disabling disease with more frequent flares, suggesting increased levels of inflammation.

This disproportionate amount of inflammation in younger patients and women with IBD may explain why they had such a markedly higher risk of heart attacks, he suggested.

“Our study adds considerably to a growing set of literature highlighting the importance of chronic inflammation in IBD as having a role in the development of heart disease,” Dr Panhwar said.

“Our findings suggest that IBD should be considered an independent risk factor for heart disease … and emphasise the need for aggressive risk factor reduction in IBD,” he added.

The results also suggested that clinicians should take seriously any symptoms suggestive of heart disease, such as chest pain, in patients with IBD, especially in younger patients, said Dr Panhwar.

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