Does coeliac disease increase cardiovascular risk?

Coeliac disease does not appear to elevate the risk of cardiovascular events, reveals a study, adding that previous associations may have reflected residual confounding rather than a direct pathogenic link.

The investigators used the TriNetX Global Collaborative Network, consisting of anonymized electronic health records from >150 million individuals worldwide. They compared adults with coeliac disease with controls without coeliac disease and applied propensity-score matching (PSM) on demographics, comorbidities, laboratory parameters, and cardiovascular medications.

A total of 41,071 patients per cohort were followed for a mean of 4.2 years after PSM. Adults with coeliac disease showed lower risks of all-cause death (hazard ratio [HR], 0.75, 95 percent confidence interval [CI], 0.71‒0.80), acute myocardial infarction (HR, 0.76, 95 percent CI, 0.67‒0.88), and incident heart failure (HR, 0.91, 95 percent CI, 0.85‒0.98) than controls.

No significant between-group differences were observed for ischaemic stroke or thromboembolism, atrial fibrillation, tachycardia/ventricular fibrillation or cardiac arrest, acute pulmonary edema, or cardiogenic shock, myocarditis, or pericarditis.

“Coeliac disease is an immune-mediated enteropathy increasingly recognized as a systemic disorder with potential cardiovascular involvement,” the investigators said. “Prior studies suggested a modestly higher risk of atrial fibrillation and cardiovascular disease, though traditional risk factors such as hypertension, hyperlipidaemia, and obesity are less common in this population.”