title: Effect of Inflammatory Bowel Disease-Related Characteristics and Treatment Interventions on Cardiovascular Disease Incidence.
abstract: BACKGROUND
  An association between inflammatory bowel disease (IBD) and cardiovascular diseases has been shown in multiple studies. However, little is known about the effect of IBD-related characteristics on cardiovascular events.
  
  
  METHODS
  The authors conducted a retrospective, nested case-control study of IBD patients who presented to the institution from 2000 to 2004, allowing for a 10-year follow-up period. One hundred eleven patients who developed cardiovascular events (cases) and 222 patients who did not develop cardiovascular events (cases) were included in the study after matching for Framingham cardiovascular risk score (2008). Relationships between predictor variables and cardiovascular outcome were assessed by conditional logistic regression.
  
  
  RESULTS
  The cases and controls were similar in age, gender, smoking and cholesterol level. There was no difference in disease subtype (ulcerative colitis or Crohn's disease). On conditional logistic regression, thiopurine treatment (odds ratio [OR]: 0.42, 95% confidence interval [CI]: 0.19-0.87; P = 0.02) was associated with decreased cardiovascular events and tumor necrosis factor alpha antagonist use (OR: 2.63, 95% CI: 1.49-4.63; P = 0.001) was associated with increased cardiovascular events. Although not statistically significant, disease-related surgery (OR: 0.57, 95% CI: 0.32-1.02; P = 0.06) was associated with decreased cardiovascular events and disease-related hospitalization (OR: 1.58, 95% CI: 0.96-2.57; P = 0.07) was associated with increased incidence of cardiovascular disorders.
  
  
  CONCLUSIONS
  The authors observed decreased incidence of cardiovascular diseases in patients with IBD who were treated with thiopurines and increased incidence of cardiovascular outcomes among patients treated with tumor necrosis factor alpha antagonist.
authors.affiliation: Departments of Internal Medicine (SDT, HH, WI) and Gastroenterology (JS, SMJ), Henry Ford Hospital, Madison Heights, Michigan.
authors.forename: Sudeep D
authors.initials: SD
authors.lastname: Thapa
authors.forename: Hiba
authors.initials: H
authors.lastname: Hadid
authors.forename: Jason
authors.initials: J
authors.lastname: Schairer
authors.forename: Waseem
authors.initials: W
authors.lastname: Imam
authors.forename: Syed-Mohammed
authors.initials: SM
authors.lastname: Jafri
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001379:Azathioprine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology* / Q000601:surgery; D016015:Logistic Models; D008297:Male; D015122:Mercaptopurine / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D014409:Tumor Necrosis Factor-alpha; D015122:Mercaptopurine; D001379:Azathioprine