IBD patients who undergo coronary intervention at increased risk of MACE

Patients with inflammatory bowel disease (IBD) have a higher likelihood of experiencing major adverse cardiovascular events (MACE) after coronary interventions, according to a study.

The nationwide cohort study included adult patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), with 987 patients with IBD being propensity score-matched to 9,571 comparators without IBD.

MACE, the primary outcome, was defined as a composite of acute myocardial infarction, stroke, hospitalization for heart failure, or mortality. Secondary outcomes included each MACE component, 30-day all-cause readmission, revascularization, and in-hospital outcomes including intensive care unit admission and length of hospital stay.

Over a median follow-up of 3.5 years, MACE occurred in 49.4 percent of patients in the IBD group and in 40.3 percent of those in the comparator group. The corresponding incidence rates were 96.5 and 68.9 per 10,000 person-years, which translated to one additional MACE for every 36 patients with IBD over 10 years. IBD was associated with a 37-percent increased risk of MACE (hazard ratio [HR], 1.37, 95 percent CI, 1.24–1.52).

Furthermore, the risk of each MACE component was higher in the IBD group than in the comparator group, with the exception of stroke.

Findings did not significantly differ between the IBD subtypes or the type of coronary intervention (PCI vs CABG). The risk of MACE was highest in IBD patients who were older and had had elective interventions.