title: The characterisation and risk factors of ischaemic heart disease in patients with coeliac disease.
abstract: BACKGROUND
  Studies have shown an increased risk of ischaemic heart disease (IHD) in patients with coeliac disease (CD), despite the patients' lack of traditional IHD risk factors.
  
  
  OBJECTIVE
  To characterise IHD according to CD status.
  
  
  METHODS
  Data on duodenal or jejunal biopsies were collected in 2006-2008 from all 28 pathology departments in Sweden and were used to define CD (equal to villous atrophy; Marsh stage 3). We used the Swedish cardiac care register SWEDEHEART to identify IHD and to obtain data on clinical status and risk factors at time of first myocardial infarction for this case-only comparison. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). CD patients were compared with general population reference individuals.
  
  
  RESULTS
  We identified 1075 CD patients and 4142 reference individuals with subsequent IHD. CD patients with myocardial infarction had lower body mass index (P < 0.001) and cholesterol values (P < 0.001) and were less likely to be active smokers (OR = 0.74; 95% CI = 0.56-0.98) than reference individuals with myocardial infarction. CD patients had less extensive coronary artery disease at angiography (any stenosis: OR = 0.80; 95% CI = 0.66-0.97; three-vessel disease: OR = 0.73; 95% CI = 0.57-0.94); but there was no difference in the proportions of CD patients with positive biochemical markers of myocardial infarction (CD: 92.2% vs. reference individuals: 91.5%, P = 0.766).
  
  
  CONCLUSIONS
  Despite evidence of an increased risk of IHD and higher cardiovascular mortality, patients with coeliac disease with IHD have a more favourable cardiac risk profile compared with IHD in reference individuals.
authors: Vårdcentralen Värmlands Nysäter, Värmland County, Sweden. lojsankik@hotmail.com
authors: L
authors: L
authors: Emilsson
authors: R
authors: R
authors: Carlsson
authors: M
authors: M
authors: Holmqvist
authors: S
authors: S
authors: James
authors: J F
authors: JF
authors: Ludvigsson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002446:Celiac Disease / Q000150:complications* / Q000453:epidemiology; D016208:Databases, Factual; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D016017:Odds Ratio; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology