Outcomes of Percutaneous Coronary Intervention in Patients with Crohn’s Disease and Ulcerative Colitis (from a nationwide cohort)

Abstract

Patients with inflammatory bowel disease (IBD) are at an increased risk of ischemic heart disease. However, there is limited evidence on how their outcomes after percutaneous coronary intervention (PCI) compare to those without IBD. All PCI-related hospitalizations from the National Inpatient Sample between 2004 and 2015 were included, stratified into three groups: no-IBD, Crohn’s disease (CD) and ulcerative colitis (UC). We assessed the association between IBD subtypes and in-hospital outcomes. A total of 6,689,292 PCI procedures were analyzed, of which 0.3% (n=18,910) had an IBD diagnosis. The prevalence of IBD increased from 0.2% (2004) to 0.4% (2015). Patients with IBD were less likely to have conventional cardiovascular risk factors and more likely to undergo PCI for an acute indication, and to receive bare metal stents. In comparison to patients without IBD, those with IBD had reduced or similar adjusted odds ratios (OR) of MACCE (CD: OR 0.69, 95% confidence interval (CI) 0.62-0.78; UC: OR 0.75, 95%CI 0.66-0.85), mortality (CD: OR 0.94, 95%CI 0.79-1.11; UC: OR 0.35, 95%CI 0.27-0.45) or acute CVA (CD: OR 0.73, 95%CI 0.60-0.89; UC: OR 0.94, 95%CI 0.77-1.15). However, IBD patients had an increased odds for major bleeding (CD: OR 1.42 95%CI 1.23-1.63 and UC: OR 1.35 95%CI 1.16-1.58). In summary, IBD is associated with a decreased risk of in-hospital post-PCI complications other than major bleeding that was significantly higher in this group. Long term follow-up is required to evaluate the safety of PCI in IBD patients from both bleeding and ischemic perspectives.

Citation

Nolan, & Mamas. (2020). Outcomes of Percutaneous Coronary Intervention in Patients with Crohn’s Disease and Ulcerative Colitis (from a nationwide cohort). American Journal of Cardiology, 30-36. https://doi.org/10.1016/j.amjcard.2020.06.013

• Acceptance Date: Jun 3, 2020
• Publication Date: Jun 17, 2020
• Journal: American Journal of Cardiology
• Print ISSN: 0002-9149
• Publisher: Elsevier
• Pages: 30-36
• DOI: https://doi.org/10.1016/j.amjcard.2020.06.013
• Keywords: Percutaneous coronary intervention, inflammatory bowel disease, Crohn’s disease, ulcerative colitis, outcomes
• Publisher URL: https://doi.org/10.1016/j.amjcard.2020.06.013