Inflammatory Bowel Disease Patients Face 19% Higher Heart Failure Risk

<p>Background and Aims</p><p>Dysregulation of inflammatory and immune responses has been implicated in the pathogenesis of heart failure (HF). But even if inflammation is a prerequisite for inflammatory bowel disease (IBD), little is known about HF risk in IBD.</p><p>Methods</p><p>In this Swedish nationwide cohort, patients with biopsy-confirmed IBD were identified between 1969 and 2017 [<em>n</em> = 81 749, Crohn’s disease (CD, <em>n</em> = 24 303), ulcerative colitis (UC, <em>n</em> = 45 709), and IBD-unclassified (IBD-U, <em>n</em> = 11 737)]. Each patient was matched with up to five general population reference individuals (<em>n</em> = 382 190) and IBD-free full siblings (<em>n</em> = 95 239) and followed until 31 December 2019. Flexible parametric survival models estimated the adjusted hazard ratio (aHR) and standardized cumulative incidence for HF, with 95% confidence intervals (CI).</p><p>Results</p><p>There were 5582 incident HF identified in IBD patients (incidence rate [IR]: 50.3/10 000 person-years) and 20 343 in reference individuals (IR: 37.9) during a median follow-up of 12.4 years. IBD patients had a higher risk of HF than reference individuals (aHR 1.19, 95% CI 1.15–1.23). This increased risk remained significant ≥20 years after IBD diagnosis, leading to one extra HF case per 130 IBD patients until then. The increased risk was also observed across IBD subtypes: CD (IR: 46.9 vs. 34.4; aHR 1.28 [1.20–1.36]), UC (IR: 50.1 vs. 39.7; aHR 1.14 [1.09–1.19]), and IBD-U (IR: 60.9 vs. 39.0; aHR 1.28 [1.16–1.42]). Sibling-controlled analyses showed slightly attenuated association (IBD: aHR 1.10 [1.03–1.19]).</p><p>Conclusions</p><p>Patients with IBD had a moderately higher risk of developing HF for ≥20 years after IBD diagnosis than the general population.</p>