Dig Liver Dis. 2025 Feb 10:S1590-8658(25)00206-3. doi: 10.1016/j.dld.2025.01.195.Online ahead of print.

Alfredo Papa ¹, Lucrezia Laterza ², Valerio Papa ³, Loris Riccardo Lopetuso ⁴, Stefania Colantuono ⁵, Gaetano Coppola ⁵, Benedetta Simeoni ⁶, Franco Scaldaferri ¹, Francesco Franceschi ⁷, Antonio Gasbarrini ¹, Marcello Covino ⁷

Author information

¹Centre for Digestive Diseases (CEMAD) and Gastroenterology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Università Cattolica del S. Cuore, Rome, Italy.

²Centre for Digestive Diseases (CEMAD) and Gastroenterology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Università Cattolica del S. Cuore, Rome, Italy. Electronic address: lucrezia.laterza@policlinicogemelli.it.

³Università Cattolica del S. Cuore, Rome, Italy; Digestive Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.

⁴Centre for Digestive Diseases (CEMAD) and Gastroenterology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy; Department of Medicine and Ageing Sciences, G. D'Annunzio University of Chieti-Pescara, Chieti, Italy; Center for Advanced Studies and Technology (CAST), G. D'Annunzio University of Chieti-Pescara, Chieti, Italy.

⁵Centre for Digestive Diseases (CEMAD) and Gastroenterology Unit, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.

⁶Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.

⁷Università Cattolica del S. Cuore, Rome, Italy; Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy.

Abstract

Objectives: Atherosclerotic cardiovascular disease (ASCVD) and venous thromboembolism (VTE) are severe complications of inflammatory bowel disease (IBD). Risk factors for ASCVD and VTE in IBD are not entirely elucidated. This study investigated the incidence and risk factors for ASCVD and VTE in IBD compared to acute infective gastroenteritis and colitis (AGC).

Methods: We reviewed the clinical records of inpatients with IBD and AGC over 6 years. Each group's propensity score-matched (PS) subpopulation consisted of 831 patients, ensuring a balanced comparison. Additionally, the effect of IBD on ASCVD and VTE was assessed.

Results: The PS cohorts indicated a significantly higher number of ASCVD events in IBD than controls (10.1 % vs. 5.5 %, p = 0.001) and an increased prevalence of ischemic heart disease (IHD) (7.9 % vs. 3.6 %, p < 0.001). Conversely, the study groups demonstrated similar VTE incidence. IBD diagnosis, male sex, hypertension, diabetes, and the Charlson Index were independently associated with ASCVD. Age was significantly associated with VTE.

Conclusions: Inpatients with IBD demonstrated an increased risk of ASCVD and IHD. IBD was an independent risk factor for ASCVD, and chronic inflammation was a significant enhancer factor for ASCVD. Aggressive control of inflammation is an essential target to reduce ASCVD risk.