IBD tied to higher risks of MACE, recurrent MI, all-cause mortality

Patients with inflammatory bowel disease (IBD) are at increased risks of major adverse cardiovascular events (MACE), all-cause mortality, recurrent myocardial infarction (MI), blood transfusions, and major bleeding relative to those without IBD, a study has found.

The authors conducted a systematic review and meta-analysis following the PRISMA guidelines. They searched through five databases from inception to July 2025 and identified observational studies comparing post-MI outcomes in adults with and without IBD.

Hazard ratios (HRs) and odds ratios (ORs) with 95 percent confidence intervals (CIs) were estimated with random-effects meta-analyses, while heterogeneity was assessed using the I² statistic.

Nine retrospective cohort studies including a total of 9.45 million patients met the eligibility criteria.

IBD significantly correlated with a higher risk of MACE (HR, 1.31, 95 percent CI, 1.07‒1.59), all-cause mortality (HR, 1.25, 95 percent CI, 1.12‒1.39), and recurrent MI (HR, 1.22, 95 percent CI, 1.08‒1.39) following an index MI relative to no IBD.

Furthermore, patients with IBD were more likely to develop major bleeding (OR, 1.38, 95 percent CI, 1.13‒1.70) and undergo transfusion (OR, 1.41, 95 percent CI, 1.35‒1.47) but less likely to have heart failure (OR, 0.81, 95 percent CI, 0.74‒0.89) and had no increased odds of stroke compared with those without IBD.

“These findings emphasize the potential role for tailored cardiovascular risk stratification, bleeding risk mitigation, and longitudinal management strategies in patients with IBD,” the authors said.

“IBD is a chronic systemic inflammatory disorder associated with elevated cardiovascular risk. While prior studies have linked IBD to increased risk of MI, post-MI outcomes in this population remain poorly characterized,” they said.