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Long-term risk of arrhythmias in patients with inflammatory bowel disease: A population-based, sibling-controlled
Jiangwei Sun1, Bjorn Roelstraete1, Emma Svennberg2
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Plos Medicine
|October 19, 2023
Summary
Patients with inflammatory bowel disease (IBD) face a higher long-term risk of developing arrhythmias, including atrial fibrillation and ventricular arrhythmias. This increased risk persists for at least 25 years post-diagnosis, highlighting the need for increased clinical awareness.
Area of Science:
- Gastroenterology and Cardiology
- Epidemiology of chronic diseases
- Inflammatory bowel disease (IBD) research
Background:
- Existing evidence suggests a link between inflammatory bowel disease (IBD) and cardiovascular disease (CVD).
- The specific association between IBD and the risk of developing arrhythmias remains unclear.
- This study investigates the long-term incidence of arrhythmias in patients diagnosed with IBD.
Purpose of the Study:
- To determine the long-term risk of developing arrhythmias in patients with Crohn's disease (CD), ulcerative colitis (UC), and IBD-unclassified (IBD-U).
- To compare arrhythmia incidence in IBD patients with matched reference individuals and IBD-free siblings.
- To assess the persistence of arrhythmia risk over time following IBD diagnosis.
Main Methods:
- Utilized a nationwide Swedish histopathology cohort (1969-2017) to identify patients with biopsy-confirmed IBD (CD, UC, IBD-U) and matched controls.
- Employed flexible parametric survival models to estimate adjusted hazard ratios (aHR) for overall and specific arrhythmias.
- Conducted sibling comparison analyses to confirm findings and adjusted for numerous demographic and clinical covariates.
Main Results:
- Patients with CD, UC, and IBD-U exhibited significantly increased risks of overall arrhythmias compared to reference individuals (aHRs ranging from 1.14 to 1.30).
- The elevated risk of arrhythmias persisted for 25 years post-diagnosis, with specific types like atrial fibrillation and ventricular arrhythmias being more common.
- Sibling analyses corroborated the increased arrhythmia risk associated with IBD, with the exception of bradyarrhythmias.
Conclusions:
- Patients diagnosed with IBD have a significantly elevated long-term risk of developing various arrhythmias.
- This increased risk is sustained for at least 25 years after the initial IBD diagnosis.
- Healthcare professionals should maintain heightened awareness of the cardiovascular implications, specifically arrhythmias, in patients with IBD.
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