No increased risk of myocardial infarction among patients with ulcerative colitis or Crohn's disease

Background & aims: Patients with chronic inflammatory diseases such as rheumatoid arthritis, systemic lupus erythematosus, and psoriasis have an increased risk of myocardial infarction (MI). Studies of the risk of MI among patients with inflammatory bowel disease have provided inconsistent results. We aimed to determine the risk of first-time acute MI in patients with ulcerative colitis (UC) or Crohn's disease (CD) compared with patients from general practice.

Methods: We conducted 2 retrospective cohort studies using the General Practice Research Database. A total of 15,498 UC patients were matched to 144,605 general practice patients (for age, sex, year of enrollment in the General Practice Research Database, and general practice of attendance) and were followed up for a mean of 4.7 years; 9829 CD patients were matched to 92,987 patients from general practice and followed up for a mean of 4.5 years. Univariable and multivariable Cox regression analyses were adjusted for age, sex, history of hypertension, diabetes mellitus, hypercholesterolemia, smoking status, body mass index, and aspirin use for each cohort.

Results: Patients with UC had a significantly increased risk of first-time acute MI compared with patients from general practice in unadjusted, but not adjusted, analysis (adjusted hazard ratio, 1.11; 95% confidence interval, 0.98-1.27). Patients with CD did not have an increased risk of MI in either unadjusted or adjusted analyses (adjusted hazard ratio, 1.09; 95% confidence interval, 0.89-1.34).

Conclusions: Unlike some other chronic inflammatory diseases, inflammatory bowel disease is not associated with an increased risk of MI.