Outcomes of Percutaneous Coronary Intervention in Patients With Crohn's Disease and Ulcerative Colitis (from a Nationwide Cohort)

Abstract

Patients with inflammatory bowel disease (IBD) are at an increased risk of ischemic heart disease. However, there is limited evidence on how their outcomes after percutaneous coronary intervention (PCI) compare to those without IBD. All PCI-related hospitalizations from the National Inpatient Sample between 2004 and 2015 were included, stratified into three groups: no-IBD, Crohn's disease (CD) and ulcerative colitis (UC). We assessed the association between IBD subtypes and in-hospital outcomes. A total of 6,689,292 PCI procedures were analyzed, of which 0.3% (n=18,910) had an IBD diagnosis. The prevalence of IBD increased from 0.2% (2004) to 0.4% (2015). Patients with IBD were less likely to have conventio na l cardiovascular risk factors and more likely to undergo PCI for an acute indication, and to receive bare metal stents. In comparison to patients without IBD, those with IBD had reduced or similar adjusted odds ratios (OR) of MACCE (CD: OR 0.69, 95% confidence interval (CI)

Impact of the number of modifiable risk factors on clinical outcomes after percutaneous coronary intervention: An analysis from the e-Ultimaster registry

“…We observed that SMuRF-less patients were younger, more likely to be male and had a lower BMI with less complex coronary artery disease. This high rate of patients with significant coronary artery disease requiring PCI but without ‘traditional’ risk factor should encourage further research to identify other risk factor, such as (but not limited to) inflammatory diseases [13] , [14] . As out results are based on a cohort, we could not assess the prevalence of inflammatory disease in the SMuRFless population of to look at other factors as CRP.…”

Clinical characteristics and outcomes of patients with chronic systemic inflammatory disease in acute myocardial infarction

“…Previous large-scale retrospective studies in Australia, Finland, and the United States reported the prevalence of RA and SLE as 0.9–2.8% and 0.1–0.4% among patients with acute MI [ 9 – 12 ], which is in line with our results. Similarly, in a nationwide PCI cohort in the United States, IBDs (Crohn’s disease and ulcerative colitis) were found in 0.3% [ 18 ]. A prospective registry in France evaluated long-term ischemic outcomes after ST-segment elevation MI in patients with integrated chronic inflammatory diseases (prevalence 4.6%), in which RA was a leading disorder (1.0%) as was seen in the present study and others, but psoriasis (0.9%), ankylosing spondylitis (0.9%), and giant cell arteritis (0.8%) were the second common disorders among CSIDs [ 40 ].…”

“…An inpatient healthcare database study in the United States showed that among patients undergoing PCI, the presence of autoimmune rheumatic diseases such as RA, SLE, and SSc was associated with an increased risk of in-hospital bleeding events, especially in those with SLE and SSc [ 17 ]. With the same inpatient database, the presence of IBDs was also reported to be related to bleeding risks during hospitalization [ 18 ]. Although these findings suggested a predisposition to bleeding in patients with CSIDs, major bleeding outcomes during hospitalization did not differ significantly between those with and without CSIDs in the present study, and data on long-term bleeding events are limited.…”

What Links an Increased Cardiovascular Risk and Inflammatory Bowel Disease? A Narrative Review

“…Finally, the study of Kobo O. et al assessed the complications following the supercutaneous coronary intervention in IBD patients. This study showed that IBD was associated with a lower risk of in-hospital complications following percutaneous coronary intervention (PCI) other than severe haemorrhage [ 41 ], which indicates that appropriate and effective treatment of IBD may be the basis for reducing the risk of ACS and reducing complications after PCI.…”