Increased risk of major adverse cardiovascular events after first-time myocardial infarction in active inflammatory bowel disease: A nationwide cohort study Outstanding Poster Award

Aim: As inflammatory bowel disease (IBD) is associated with an increased cardiovascular risk, the effect of active IBD was examined on major adverse cardiovascular outcomes after myocardial infarction (MI). Methods: From 2002 to 2011 86,790 patients with first-time MI were identified, including 1,030 with IBD from nationwide registries. IBD activity was categorized into either flares; persistent activity or remission. Hazard ratios (HRs) of recurrent MI and all-cause mortality, and a composite of recurrent MI, cardiovascular death, and stroke were estimated in patients alive seven days after discharge, whereas short-term mortality defined as death during hospitalization or within seven days of discharge was assessed using logistic regression. Results: Among 75,288 patients alive, IBD-associated HRs were 1.12 (95% confidence interval 0.95-1.38) for recurrent MI, 1.16 (1.03-1.30) for all-cause mortality, and 1.10 (0.97-1.24) for the composite endpoint. IBD flares were associated with a markedly increased risk of recurrent MI 2.70 (1.63-4.48), all-cause mortality 2.47 (1.83-3.35) and the composite endpoint 1.80 (1.21-2.66). No increased risk was identified in quiescent stages. Odds ratios for short-term mortality (n=11,502 including 138 with IBD) corresponded to 1.74 (1.09-2.77) for patients with flares of IBD, 1.25 (0.71-2.20) for persistent activity, and 0.92 (0.74-1.14) for those in remission. Conclusion: Active inflammatory bowel disease worsens the prognosis after myocardial infarction.