No Increased Risk of Myocardial Infarction Among Patients With Ulcerative Colitis or Crohn's Disease
No Increased Risk of Myocardial Infarction Among Patients With Ulcerative Colitis or Crohn's Disease
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DOI：
10.1016/j.cgh.2011.06.032
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发表时间：
2011-10-01
影响因子：
12.6
通讯作者：
Lewis, James D.
中科院分区：
文献类型：
--
作者：
Osterman, Mark T.;Yang, Yu-Xiao;Lewis, James D.
背景与目的：慢性炎症性疾病如类风湿性关节炎、系统性红斑狼疮和银屑病患者发生心肌梗死（MI）的风险增加。关于炎症性肠病患者MI风险的研究提供了不一致的结果。我们的目的是确定溃疡性结肠炎（UC）或克罗恩病（CD）患者与全科患者相比首次急性心肌梗死的风险。方法：我们使用全科医学研究数据库进行了2项回顾性队列研究。共有15，498例UC患者与144，605例全科患者（年龄、性别、全科研究数据库中的入组年份和全科就诊时间）匹配，平均随访4.7年; 9829例CD患者与92，987例全科患者匹配，平均随访4.5年。单变量和多变量考克斯回归分析校正了每个队列的年龄、性别、高血压、糖尿病、高胆固醇血症、吸烟状况、体重指数和阿司匹林使用情况。研究结果：在未校正但未校正的分析中，UC患者的首次急性MI风险显著高于全科医生（校正风险比，1.11; 95%置信区间，0.98-1.27）。在未校正或校正分析中，CD患者的MI风险均未增加（校正风险比，1.09; 95%置信区间，0.89-1.34）。结论：与其他一些慢性炎症性疾病不同，炎症性肠病与MI风险增加无关。
BACKGROUND & AIMS: Patients with chronic inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, and psoriasis have an increased risk of myocardial infarction (MI). Studies of the risk of MI among patients with inflammatory bowel disease have provided inconsistent results. We aimed to determine the risk of first-time acute MI in patients with ulcerative colitis (UC) or Crohn's disease (CD) compared with patients from general practice. METHODS: We conducted 2 retrospective cohort studies using the General Practice Research Database. A total of 15,498 UC patients were matched to 144,605 general practice patients (for age, sex, year of enrollment in the General Practice Research Database, and general practice of attendance) and were followed up for a mean of 4.7 years; 9829 CD patients were matched to 92,987 patients from general practice and followed up for a mean of 4.5 years. Univariable and multivariable Cox regression analyses were adjusted for age, sex, history of hypertension, diabetes mellitus, hypercholesterolemia, smoking status, body mass index, and aspirin use for each cohort. RESULTS: Patients with UC had a significantly increased risk of first-time acute MI compared with patients from general practice in unadjusted, but not adjusted, analysis (adjusted hazard ratio, 1.11; 95% confidence interval, 0.98-1.27). Patients with CD did not have an increased risk of MI in either unadjusted or adjusted analyses (adjusted hazard ratio, 1.09; 95% confidence interval, 0.89-1.34). CONCLUSIONS: Unlike some other chronic inflammatory diseases, inflammatory bowel disease is not associated with an increased risk of MI.