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DOP071. Inflammatory bowel diseases: a new cardiovascular risk factor?

L. Caillo1, G. Danan1, V. Georgescu2, L. Papineau1, F. Gonzalez1, J.-F. Bourgaux3, F. Guillon4, G.-P. Pageaux1, R. Altwegg1, 1University Hospital of St Eloi, Departement of Hepatology and Gastroenterology, Montpellier, France, 2University Hospital, Department of Medical Information, Montpellier, France, 3University Hospital, Department of Hepatology and Gastroenterology, Nimes, France, 4University Hospital of St Eloi, Department of Digestive Surgery, Montpellier, France

Background

Inflammatory Bowel Diseases (IBD) are associated with systemic inflammation and hypercoagulability. Chronic inflammation is a well-known factor of atherosclerosis, but few data showed an over-risk of cardiovascular events in IBD patients. The objective of this study was to evaluate the prevalence of cardiovascular events in patients with IBD compared to the general population.

Methods

Between 2004 and 2013, an historic longitudinal cohort study has been performed, analyzing data from French regional registers (SNIIRAM) of patients' health care system (ALD). A comparison has been made between IBD patients and general population data. The risk of cardiovascular events was estimated from reports of ALD during the monitoring period: stroke, peripheral arterial disease, type 1 and type 2 diabetes, high blood pressure, coronary artery disease.

Results

Between the 1st January of 2004 and the 30th September of 2013, 3727 patients with diagnosis of IBD were registered in health insurance in our regional area. The median age was 40.7 years (5–95). Fifty-five percent were women. The distribution was 55.7% (n = 2076) for Crohn's disease (CD) and 44.3% (n = 1651) for ulcerative colitis (UC). IBD patients were compared during the same period to 2 112.829 patients insured in the general health care system.

The prevalence of cardiovascular events was significantly higher in the IBD group than in the general population: stroke (1.1% vs. 0.53%, p < 0.01), peripheral arterial disease (1.2% versus 0.8%, p < 0.01), coronary artery disease (3.1% versus 1.7%, p < 0.01). The association with cardiovascular risk factors such as severe high blood pressure (2.7% vs. 1.8%, p < 0.01) and type 1 and type 2 diabetes (5% versus 3.3%, p < 0.01) was significantly higher in the IBD group. Finally, in the IBD group, the prevalence of cardiovascular events was higher in UC population (14.2%) than in the CD population (8.8%) (p < 0.001).

Conclusion

The prevalence of cardiovascular events and cardiovascular risk factors were higher in the IBD group compared to the general population, especially among patients followed for UC. Further studies should be conducted to assess the impact of IBD as a cofactor or independent risk factor for cardiovascular diseases.