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IBD Linked to Worse Prognosis After Myocardial Infarction

IBD flares linked to increased risks of recurrent MI, all-cause mortality, composite outcome

WEDNESDAY, Oct. 15, 2014 (HealthDay News) -- For patients after first-time myocardial infarction (MI), inflammatory bowel disease (IBD) is associated with worse prognosis, according to a study published online Oct. 14 in Circulation: Cardiovascular Quality and Outcomes.

Søren Lund Kristensen, M.D., Ph.D., from the Copenhagen University Hospital Gentofte in Denmark, and colleagues examined the effect of active IBD on the outcomes of 86,790 patients after MI. Of these, 1,030 patients had IBD, and their disease was categorized as flare, persistent activity, or remission.

The researchers found that compared with the non-IBD group, the odds ratio for death during hospitalization or within 30 days of discharge was 3.29 (95 percent confidence interval [CI], 1.98 to 5.45) for patients with IBD flares, 1.62 for persistent activity (95 percent CI, 0.95 to 2.77), and 0.97 for remission (95 percent CI, 0.78 to 1.19). Among the patients alive 30 days after discharge, IBD correlated with hazard ratios of 1.21 (95 percent CI, 0.99 to 1.49) for recurrent MI, 1.14 (95 percent CI, 1.01 to 1.28) for all-cause mortality, and 1.17 for the composite end point (recurrent MI, cardiovascular death, and stroke; 95 percent CI, 1.03 to 1.34). IBD flares were associated with increased risks of recurrent MI, all-cause mortality, and the composite end point (hazard ratios, 3.09, 2.25, and 2.04) compared with the non-IBD group, but there was no increased risk seen in remission.

"Active inflammatory bowel disease worsens prognosis after MI, in particular, in relation with flares," the authors write.

One author was supported by a scholarship from the Novo Nordisk Foundation.

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