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Outcomes after acute coronary syndrome in patients with inflammatory bowel disease

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Abstract

Background

Patients with chronic inflammatory conditions are at an increased risk of developing atherothrombotic events. We aimed to assess the 1-year prognosis after myocardial infarction (MI) in patients with inflammatory bowel disease (IBD).

Methods

From the PMSI (Program de Medicalisation des Systèmes d’informatique) database, 246 out of 39,835 consecutive MI patients, hospitalized between 2012 and 2017, were diagnosed with IBD and followed up for 1 year after discharge. A matched cohort was built matching each MI patient with IBD to patient without IBD using age and sex (n = 1,470, matching ratio 1:5).

Results

Compared with MI patients without IBD, MI patients with IBD were younger (aged 69 vs. 70.8 years, p = 0.04) with a higher rate of increased body mass index (BMI) (21.5% vs 15%, p = 0.004), previously diagnosed ischemic cardiopathy (18.3% vs 12.6%, p < 0.0008) and chronic renal disease (8.9% vs 5.6%, p = 0.02). In our age- and sex-matched cohort, we found that all-cause mortality (9% vs 8.3, p = 0.729), stroke (0.8% vs 0.6%, p = 0.656) and hospitalization resulting from heart failure (3ool, .3% vs 3.5%, p = 0.846) did not significantly differ between the IBD and non-IBD groups within the first year after initial admission whereas the risk of recurrent MI was increased by 50% (2.9% vs 1.9%, p = 0.33) in the IBD group without reaching statistical significance. Moreover, a significant increase in the blood transfusion rate at the 1-year follow-up was observed in MI patients with IBD compared with MI patients without IBD (15.1% vs 9.4%, p < 0.001).

Conclusion

Our findings suggest that both residual MI risk and bleeding events should be carefully monitored in MI patients diagnosed with chronic inflammation such as that observed in IBD.

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References

  1. Frostegard J (2005) Atherosclerosis in patients with autoimmune disorders. Arterioscler Thromb Vasc Biol 25(9):1776–1785

    Article  CAS  Google Scholar 

  2. Roifman I, Beck PL, Anderson TJ, Eisenberg MJ, Genest J (2011) Chronic inflammatory diseases and cardiovascular risk: a systematic review. Can J Cardiol 27(2):174–182

    Article  Google Scholar 

  3. Ross R (1999) Atherosclerosis–an inflammatory disease. N Engl J Med 340(2):115–126

    Article  CAS  Google Scholar 

  4. Libby P (2002) Inflammation in atherosclerosis. Nature 420(1617):868–874

    Article  CAS  Google Scholar 

  5. Wolf D, Ley K (2019) Immunity and Inflammation in Atherosclerosis. Circ Res 124(2):315–327

    Article  CAS  Google Scholar 

  6. Wu GC, Leng RX, Lu Q, Fan YG, Wang DG, Ye DQ (2017) Subclinical atherosclerosis in patients with inflammatory bowel diseases: a systematic review and meta-analysis. Angiology 68(5):447–461

    Article  Google Scholar 

  7. Hatoum OA, Binion DG (2005) The vasculature and inflammatory bowel disease: contribution to pathogenesis and clinical pathology. Inflamm Bowel Dis 11(3):304–313

    Article  Google Scholar 

  8. Ha C, Magowan S, Accortt NA, Chen J, Stone CD (2009) Risk of arterial thrombotic events in inflammatory bowel disease. Am J Gastroenterol 104(6):1445–1451

    Article  Google Scholar 

  9. Barnes EL, Beery RM, Schulman AR, McCarthy EP, Korzenik JR, Winter RW (2016) Hospitalizations for acute myocardial infarction are decreased among patients with inflammatory bowel disease using a nationwide inpatient database. Inflamm Bowel Dis 22(9):2229–2237

    Article  Google Scholar 

  10. Panhwar MS, Mansoor E, Al-Kindi SG, Sinh P, Katz J, Oliveira GH, Cooper GS, Ginwalla M (2019) Risk of myocardial infarction in inflammatory bowel disease: a population-based national study. Inflamm Bowel Dis 25(6):1080–1087

    Article  Google Scholar 

  11. Aniwan S, Pardi DS, Tremaine WJ, Loftus EV (2018) Increased risk of acute myocardial infarction and heart failure in patients with inflammatory bowel diseases. Clin Gastroenterol Hepatol 16(10):1607-1615e1

    Article  Google Scholar 

  12. Chantry AA, Deneux-Tharaux C, Cans C, Ego A, Quantin C, Bouvier-Colle MH, Group Gs (2011) Hospital discharge data can be used for monitoring procedures and intensive care related to severe maternal morbidity. J Clin Epidemiol 64(9):1014–1022

    Article  Google Scholar 

  13. Couris CM, Polazzi S, Olive F, Remontet L, Bossard N, Gomez F, Schott AM, Mitton N, Colonna M, Trombert B (2009) Breast cancer incidence using administrative data: correction with sensitivity and specificity. J Clin Epidemiol 62(6):660–666

    Article  Google Scholar 

  14. Herzog D, Fournier N, Buehr P, Rueger V, Koller R, Heyland K, Nydegger A, Spalinger J, Schibli S, Petit LM, Braegger CP, Swiss IBDCSG (2018) Age at disease onset of inflammatory bowel disease is associated with later extraintestinal manifestations and complications. Eur J Gastroenterol Hepatol 30(6):598–607

    Article  Google Scholar 

  15. Beaugerie L, Seksik P, Nion-Larmurier I, Gendre JP, Cosnes J (2006) Predictors of crohn’s disease. Gastroenterology 130(3):650–656

    Article  Google Scholar 

  16. Hoie O, Schouten LJ, Wolters FL, Solberg IC, Riis L, Mouzas IA, Politi P, Odes S, Langholz E, Vatn M, Stockbrugger RW, Moum B, European Collaborative Study Group of Inflammatory Bowel D (2007) Ulcerative colitis: no rise in mortality in a European-wide population based cohort 10 years after diagnosis. Gut 56(4):497–503

    Article  CAS  Google Scholar 

  17. Nic Suibhne T, Raftery TC, McMahon O, Walsh C, O’Morain C, O’Sullivan M (2013) High prevalence of overweight and obesity in adults with Crohn’s disease: associations with disease and lifestyle factors. J Crohns Colitis 7(7):e241-248

    Article  Google Scholar 

  18. Gandhi S, Narula N, Marshall JK, Farkouh M (2012) Are patients with inflammatory bowel disease at increased risk of coronary artery disease? Am J Med 125(10):956–962

    Article  Google Scholar 

  19. Andersohn F, Waring M, Garbe E (2010) Risk of ischemic stroke in patients with Crohn’s disease: a population-based nested case-control study. Inflamm Bowel Dis 16(8):1387–1392

    Article  Google Scholar 

  20. Kristensen SL, Ahlehoff O, Lindhardsen J, Erichsen R, Jensen GV, Torp-Pedersen C, Nielsen OH, Gislason GH, Hansen PR (2013) Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death–a Danish nationwide cohort study. PLoS One 8(6):e56944

    Article  CAS  Google Scholar 

  21. Kristensen SL, Ahlehoff O, Lindhardsen J, Erichsen R, Lamberts M, Khalid U, Nielsen OH, Torp-Pedersen C, Gislason GH, Hansen PR (2014) Prognosis after first-time myocardial infarction in patients with inflammatory bowel disease according to disease activity: nationwide cohort study. Circ Cardiovasc Qual Outcomes 7(6):857–862

    Article  Google Scholar 

  22. Yeh RW, Sidney S, Chandra M, Sorel M, Selby JV, Go AS (2010) Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med 362(23):2155–2165

    Article  CAS  Google Scholar 

  23. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ, Group JS (2008) Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 359(21):2195–2207

    Article  CAS  Google Scholar 

  24. Ridker PM, Everett BM, Thuren T, MacFadyen JG, Chang WH, Ballantyne C, Fonseca F, Nicolau J, Koenig W, Anker SD, Kastelein JJP, Cornel JH, Pais P, Pella D, Genest J, Cifkova R, Lorenzatti A, Forster T, Kobalava Z, Vida-Simiti L, Flather M, Shimokawa H, Ogawa H, Dellborg M, Rossi PRF, Troquay RPT, Libby P, Glynn RJ, Group CT (2017) Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease. N Engl J Med 377(12):1119–1131

    Article  CAS  Google Scholar 

  25. Danese S, Papa A, Saibeni S, Repici A, Malesci A, Vecchi M (2007) Inflammation and coagulation in inflammatory bowel disease: The clot thickens. Am J Gastroenterol 102(1):174–186

    Article  CAS  Google Scholar 

  26. Angiolillo DJ (2012) The evolution of antiplatelet therapy in the treatment of acute coronary syndromes: from aspirin to the present day. Drugs 72(16):2087–2116

    Article  CAS  Google Scholar 

  27. Secemsky EA, Yeh RW, Kereiakes DJ, Cutlip DE, Cohen DJ, Steg PG, Cannon CP, Apruzzese PK, D’Agostino RB Sr, Massaro JM, Mauri L, Dual Antiplatelet Therapy Study I (2017) Mortality following cardiovascular and bleeding events occurring beyond 1 year after coronary stenting: a secondary analysis of the dual antiplatelet therapy (DAPT) study. JAMA Cardiol 2(5):478–4877

    Article  Google Scholar 

  28. Costa F, van Klaveren D, James S, Heg D, Raber L, Feres F, Pilgrim T, Hong MK, Kim HS, Colombo A, Steg PG, Zanchin T, Palmerini T, Wallentin L, Bhatt DL, Stone GW, Windecker S, Steyerberg EW, Valgimigli M, Investigators P-DS (2017) Derivation and validation of the predicting bleeding complications in patients undergoing stent implantation and subsequent dual antiplatelet therapy (PRECISE-DAPT) score: a pooled analysis of individual-patient datasets from clinical trials. Lancet 389(10073):1025–1034

    Article  Google Scholar 

  29. Valgimigli M, Bueno H, Byrne RA, Collet JP, Costa F, Jeppsson A, Juni P, Kastrati A, Kolh P, Mauri L, Montalescot G, Neumann FJ, Petricevic M, Roffi M, Steg PG, Windecker S, Zamorano JL, Levine GN, Group ESCSD (2018) Guidelines ESCCfP and Societies ESCNC. 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: The Task Force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 39(3):213–260

    Article  Google Scholar 

  30. Rao SV, Eikelboom JA, Granger CB, Harrington RA, Califf RM, Bassand JP (2007) Bleeding and blood transfusion issues in patients with non-ST-segment elevation acute coronary syndromes. Eur Heart J 28(10):1193–1204

    Article  Google Scholar 

  31. Hebert PC, Wells G, Blajchman MA, Marshall J, Martin C, Pagliarello G, Tweeddale M, Schweitzer I, Yetisir E (1999) A multicenter, randomized, controlled clinical trial of transfusion requirements in critical care transfusion requirements in critical care. Investigators, Canadian critical care trials group. N Engl J Med 340(6):409–417

    Article  CAS  Google Scholar 

  32. Stucchi M, Cantoni S, Piccinelli E, Savonitto S, Morici N (2018) Anemia and acute coronary syndrome: current perspectives. Vasc Health Risk Manag 14:109–118

    Article  CAS  Google Scholar 

  33. Ducrocq G, Puymirat E, Steg PG, Henry P, Martelet M, Karam C, Schiele F, Simon T, Danchin N (2015) Blood transfusion, bleeding, anemia, and survival in patients with acute myocardial infarction: FAST-MI registry. Am Heart J 170(4):726-734e2

    Article  Google Scholar 

  34. Silvain J, Pena A, Cayla G, Brieger D, Bellemain-Appaix A, Chastre T, Vignalou JB, Beygui F, Barthelemy O, Collet JP, Montalescot G (2010) Impact of red blood cell transfusion on platelet activation and aggregation in healthy volunteers: results of the transfusion study. Eur Heart J 31(22):2816–2821

    Article  CAS  Google Scholar 

  35. Fransen E, Maessen J, Dentener M, Senden N, Buurman W (1999) Impact of blood transfusions on inflammatory mediator release in patients undergoing cardiac surgery. Chest 116(5):1233–1239

    Article  CAS  Google Scholar 

  36. Peyrin-Biroulet L, Reinisch W, Colombel JF, Mantzaris GJ, Kornbluth A, Diamond R, Rutgeerts P, Tang LK, Cornillie FJ, Sandborn WJ (2014) Clinical disease activity, C-reactive protein normalisation and mucosal healing in Crohn’s disease in the SONIC trial. Gut 63(1):88–95

    Article  Google Scholar 

  37. Torres J, Mehandru S, Colombel JF, Peyrin-Biroulet L (2017) Crohn’s disease. Lancet 389(10080):1741–1755

    Article  Google Scholar 

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Authors and Affiliations

  1. Département de Cardiologie, Université de Lorraine, CHRU-Nancy, 54000, Nancy, France

    Batric Popovic, Jeanne Varlot, Joseph Hennequin, Pierre Adrien Metzdorf & Edoardo Camenzind

  2. Département d’Evaluation et d’Information Médicales, Université de Lorraine, CHRU-Nancy, 54000, Nancy, France

    Nicolas Jay & Aurélie Bannay

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  1. Batric Popovic
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Popovic, B., Varlot, J., Hennequin, J. et al. Outcomes after acute coronary syndrome in patients with inflammatory bowel disease. Heart Vessels 37, 1604–1610 (2022). https://doi.org/10.1007/s00380-022-02061-8

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