title: Follow-up of ischaemic heart disease in patients with coeliac disease.
abstract: Patients with coeliac disease and myocardial infarction have a more favourable atherosclerotic risk factor profile than controls with myocardial infarction (MI). Therefore, MI prognosis and treatment may differ according to coeliac status. This paper reports on the study of Swedish MI patients with and without coeliac disease (equal to villous atrophy; Marsh histopathology stage 3) based on duodenal or jejunal biopsy data. We used the Swedish Quality Register (SWEDEHEART) to identify individuals with a record of MI from 2005 to 2008 and to obtain data on medication, coronary interventions, and clinical and laboratory parameters at 6-10 weeks and one year after first MI. One-year mortality and coronary interventions were assessed for 430 coeliac patients and 1988 controls. For other outcome variables, we compared 42 coeliac patients with MI and 201 general population controls with MI. Odds ratios (ORs) were calculated by logistic regression. The results showed that compared with controls with MI, coeliac individuals with MI had significantly higher one-year all-cause mortality (OR = 1.43; 95% confidence interval (CI) = 1.04-1.95) but less often underwent a percutaneous coronary intervention (OR = 0.77; 95% CI = 0.61-0.96). Coeliac patients were more often prescribed warfarin but less often aspirin and statins. The readmission rate due to cardiac events in coeliac patients was 15.2% vs. 12.6% in controls (p-value = 0.69). Other clinical and laboratory parameters were similar. We conclude that the follow up of MI does not seem to differ between coeliac patients and controls, and is unlikely to explain the excess mortality from cardiovascular disease noted in Swedish patients with CD.
authors: Vårdcentralen Värmlands Nysäter, Sweden Department of Medicine, Örebro University, Sweden lojsankik@hotmail.com.
authors: Louise
authors: L
authors: Emilsson
authors: PCI unit, Department of Cardiology, Central Hospital, Karlstad, Sweden.
authors: Roland
authors: R
authors: Carlsson
authors: Department of Medical Sciences, Cardiology and Uppsala Clinical Research Centre, Uppsala University, Sweden.
authors: Stefan
authors: S
authors: James
authors: Department of Cardiology and Clinical Research Centre, Falun Hospital, Sweden.
authors: Kristina
authors: K
authors: Hambraeus
authors: Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden Department of Pediatrics, Örebro University Hospital, Sweden.
authors: Jonas F
authors: JF
authors: Ludvigsson
mesh_terms: D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001706:Biopsy; D016022:Case-Control Studies; D002423:Cause of Death; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy / Q000453:epidemiology* / Q000401:mortality; D055050:Diet, Gluten-Free; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
keywords: Autoimmunity; coeliac; inflammation; myocardial infarction; risk factors