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Outcomes of Percutaneous Coronary Intervention in Patients with Inflammatory Bowel Disease
Umesh Bhagat1, Akshat Banga2, Ankit Agrawal3
1Department of Gastroenterology, Hepatology and Nutrition, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
Insights
Patients with inflammatory bowel disease (IBD) undergoing percutaneous coronary intervention (PCI) experience more gastrointestinal and cardiac complications. However, IBD did not significantly increase the risk of death after PCI.
Area of Science:
- Cardiology
- Gastroenterology
- Public Health
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease and ulcerative colitis, is linked to increased cardiovascular risks.
- The impact of IBD on outcomes after percutaneous coronary intervention (PCI) is not well understood.
Purpose of the Study:
- To assess clinical and procedural outcomes of PCI in patients with concurrent IBD.
- To compare PCI outcomes between IBD patients and non-IBD controls.
Main Methods:
- Utilized the National Readmission Database (2016-2020).
- Evaluated all-cause mortality and post-PCI complications (cardiovascular and gastrointestinal).
- Employed multivariable logistic regression and propensity-score matching for analysis.
Main Results:
- IBD patients had higher rates of GI complications, including acute liver failure, mesenteric ischemia, and need for blood transfusion.
- A significant increase in cardiac complications was observed in IBD patients.
- No significant difference in all-cause mortality was found between IBD and non-IBD groups.
Conclusions:
- IBD patients undergoing PCI face elevated risks of gastrointestinal and cardiovascular complications.
- Procedural outcomes in IBD patients are complex, influenced by systemic inflammation and vascular integrity.
- Mortality risk following PCI is not significantly altered by the presence of IBD.
Abstract:
Background: Inflammatory bowel disease (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), has been associated with elevated cardiovascular risks. However, the impact of IBD on outcomes following percutaneous coronary intervention (PCI) remains underexplored. We aimed to evaluate the clinical and procedural outcomes of PCI in patients with concurrent IBD. Methods: This study utilized the National Readmission Database from 2016 to 2020 to evaluate outcomes such as all-cause mortality and post-PCI complications, including various cardiovascular and gastrointestinal (GI) complications in IBD patients undergoing PCI. Patients with concurrent IBD and PCI were compared to non-IBD controls via multivariable logistic regression. Results: On propensity-score-matching analysis, IBD patients undergoing PCI had a higher prevalence of GI complications, including acute liver failure (Odds ratio (OR) 1.48, 95% confidence interval (CI) 1.13-1.93, p = 0.004), mesenteric ischemia (OR 5.34, 95% CI 1.56-18.40, p = 0.007), and need for blood transfusion (OR 1.74, 95% CI 1.46-2.08, p < 0.001). There was also a higher rate of cardiac complications (OR 1.31, 95% CI 1.05-1.64, p = 0.017). No significant difference in all-cause mortality (OR 0.86, 95% CI 0.72-1.04, p = 0.113) was observed. Conclusions: IBD patients undergoing PCI face increased GI and cardiovascular complications without a significant mortality difference. These findings highlight the complex interplay between systemic inflammation, vascular integrity, and procedural outcomes in IBD patients.
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