Unveiling the Link Between Inflammatory Bowel Disease and Acute Coronary Syndrome
Recent research has shed light on a significant concern in the medical community: the relationship between Inflammatory Bowel Disease (IBD) and Acute Coronary Syndrome (ACS). This systematic review and meta-analysis, published on PubMed, delves into the increased risk of ACS in patients with IBD, a topic of growing importance in both gastroenterology and cardiology.
The Source Article Details
Inflammatory bowel disease patients have an increased risk of acute coronary syndrome: a systematic review and meta-analysis by Ammar Zaka et al. in 2023.
The Source Article's Abstract
Systemic inflammation is increasingly being recognised as a possible mechanism for acute arterial thrombotic events, including acute coronary syndrome (ACS). Despite this, there is conflicting data on the risk of ACS in patients with inflammatory bowel disease (IBD). We performed a contemporary systematic review and meta-analysis to identify the risk of ACS in patients with IBD.
PubMed, MEDLINE, EMBASE, CENTRAL and Web of Science were searched up to 27 October 2022. Multivariable-adjusted or propensity matched studies with a non-IBD control cohort were included. HRs were pooled using a random-effects model. Subgroup and sensitivity analyses were conducted in order to explore sources of heterogeneity.
Twelve retrospective cohort studies were included (225,248 IBD patients). Patients with IBD were associated with an increased risk of ACS in both adjusted (HR 1.23; 95% CI 1.08 to 1.41) and unadjusted analyses (HR 1.50; 95% CI 1.16 to 1.92). Substantial heterogeneity was observed (i2=88, p=0.002 and i2=98%, p=0.002, respectively). Subgroup analysis of age revealed a greater association of ACS in IBD patients <40 years of age (relative HR 1.50; 95 CI 1.15 to 1.96).
Patients with IBD demonstrated an independently increased risk of ACS. Prospective studies are required to explore the relationship with disease activity and duration, concomitant medication use and angiographic characteristics and outcomes.
The Source Article References
- The global, regional, and national burden of inflammatory bowel disease in 195 countries and territories, 1990-2017: a systematic analysis for the global burden of disease study 2017 by Alatab, 2020 in The Lancet Gastroenterology & Hepatology
- Inflammatory bowel disease and acute coronary syndromes: from pathogenesis to the fine line between bleeding and ischemic risk by Pepe, 2021 in Inflamm Bowel Dis
- Subclinical atherosclerosis in patients with inflammatory bowel diseases: a systematic review and meta-analysis by Wu, 2017 in Angiology
- Inflammatory bowel disease and atherosclerotic cardiovascular disease: JACC review topic of the week by Cainzos-Achirica, 2020 in J Am Coll Cardiol
- Hospitalizations for acute myocardial infarction are decreased among patients with inflammatory bowel disease using a nationwide inpatient database by Barnes, 2016 in Inflammatory Bowel Diseases
- Patients with inflammatory bowel disease are at increased risk of Atherothrombotic disease: a systematic review with meta-analysis by D’Ascenzo, 2023 in Int J Cardiol
- Increased risk of ischemic heart disease and diabetes in inflammatory bowel disease by Li, 2021 in Z Gastroenterol
- Inflammatory bowel disease and cardiovascular disease incidence and mortality: a meta-analysis by Sun, 2018 in Eur J Prev Cardiol
- Disease activity in inflammatory bowel disease is associated with arterial vascular disease by Card, 2021 in Inflamm Bowel Dis
- Risk of thromboembolic events and associated healthcare costs in patients with inflammatory bowel disease by Setyawan, 2022 in Adv Ther
- Patients with inflammatory bowel disease have an increased risk of myocardial infarction: a nationwide study by Choi, 2019 in Aliment Pharmacol Ther
- Epidemiology and clinical outcomes of patients with inflammatory bowel disease presenting with acute coronary syndrome by Pemmasani, 2021 in Inflamm Bowel Dis
- Long-term risk of acute coronary syndrome in patients with inflammatory bowel disease: a 13-year nationwide cohort study in an Asian population by Tsai, 2014 in Inflamm Bowel Dis
Citing the Source Article (APA)
Zaka, A., Mridha, N., Subhaharan, D., Jones, M., Niranjan, S., Mohsen, W., Ramaswamy, P.K. (2023). Inflammatory bowel disease patients have an increased risk of acute coronary syndrome: a systematic review and meta-analysis. Open Heart, 10(2), e002483-e002483. 10.1136/openhrt-2023-002483
Methodology and Key Findings
The study meticulously analyzed data from twelve retrospective cohort studies, encompassing a substantial sample of 225,248 IBD patients. The researchers employed a random-effects model to pool hazard ratios (HRs) and conducted subgroup and sensitivity analyses to identify sources of heterogeneity.
One of the pivotal findings was the increased risk of ACS in IBD patients, particularly in those under 40 years of age. This highlights a crucial aspect of patient care and risk assessment in younger demographics.
Implications for Clinical Practice
The study’s findings have profound implications for clinical practice. Healthcare professionals should be aware of the heightened risk of ACS in IBD patients, especially when considering preventive strategies and long-term care plans. This underscores the need for a multidisciplinary approach in managing IBD patients, integrating both gastroenterological and cardiovascular perspectives.
- Increased vigilance for cardiovascular symptoms in IBD patients.
- Integration of preventive cardiovascular measures in IBD management.
- Further research to explore the underlying mechanisms linking IBD and ACS.
Further Research and Prospective Studies
While the study provides compelling evidence, it also opens the door for further research. Prospective studies are needed to explore the relationship between disease activity, duration, medication use, and angiographic characteristics in IBD patients. Such research could pave the way for more targeted and effective treatment strategies.
Moreover, understanding the nuances of this relationship could lead to breakthroughs in both the prevention and management of ACS in IBD patients, potentially improving patient outcomes significantly.
This insightful research offers a new perspective on the intersection of gastrointestinal and cardiovascular health. What are your thoughts on these findings? How do you see this influencing clinical practice? Share your insights and join the conversation below.