Impact of Inflammatory Bowel Disease on Outcomes After Coronary Interventions: A Systematic Review and Meta-Analysis

Inflammatory bowel disease (IBD) is associated with an elevated long-term cardiovascular risk through chronic systemic inflammation, yet whether it adversely affects outcomes following coronary revascularization remains uncertain. We conducted a systematic review and meta-analysis to quantify the association between IBD and clinical outcomes after percutaneous coronary intervention or coronary artery bypass grafting. MEDLINE, Embase, CENTRAL, Scopus, and Web of Science were searched from inception to June 20, 2026. Observational studies comparing patients with IBD with non-IBD controls undergoing coronary intervention and reporting at least one prespecified outcome were eligible. Five studies were included. Pooled analysis using a DerSimonian-Laird random-effects model demonstrated no statistically significant difference between IBD and non-IBD patients in the risk of major adverse cardiovascular events (MACE; risk ratio (RR) 1.01, 95% CI 0.84-1.21), all-cause mortality (RR 0.97, 95% CI 0.71-1.32), or stroke (RR 0.89, 95% CI 0.78-1.02). Heterogeneity was substantial for MACE and mortality (I² 97% and 94%, respectively) and moderate for stroke (I² 49%). Subgroup analysis revealed no significant difference in any outcome between Crohn's disease and ulcerative colitis. The pooled null result, however, masks divergent signals across studies, with the sole long-term cohort reporting a 37% relative increase in MACE, in contrast to predominantly neutral or favorable findings from in-hospital administrative analyses. IBD does not appear to significantly worsen short-term outcomes after coronary intervention, although inflammation-driven risk may accrue over longer follow-up. Prospective studies incorporating disease activity, treatment exposure, and extended surveillance are warranted.