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Nationwide cohort study of risk of ischemic heart disease in patients with celiac disease.
Circulation 2011; 123(5):483-90Circ

Abstract

BACKGROUND

Studies on ischemic heart disease (IHD) incidence in individuals with celiac disease (CD) are contradictory and do not take small intestinal pathology into account.

METHODS AND RESULTS

In this Swedish population-based cohort study, we examined the risk of IHD in patients with CD based on small intestinal histopathology. We defined IHD as death or incident disease in myocardial infarction or angina pectoris in Swedish national registers. In 2006 to 2008, we collected duodenal/jejunal biopsy data on CD (equal to villous atrophy; Marsh 3; n=28 190 unique individuals) and inflammation without villous atrophy (Marsh 1 to 2; n=12 598) from all 28 pathology departments in Sweden. A third cohort consisted of 3658 individuals with normal mucosa but positive CD serology (Marsh 0, latent CD). We found an increased risk of incident IHD in patients undergoing small intestinal biopsy that was independent of small intestinal histopathology (CD: hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.11 to 1.28; 991 events; inflammation: HR, 1.28; 95% CI, 1.19 to 1.39; 809 events; and latent CD: HR, 1.14; 95% CI, 0.87 to 1.50; 62 events). Celiac disease (HR, 1.22; 95% CI, 1.06 to 1.40) and inflammation (HR, 1.32; 95% CI, 1.14 to 1.52) were both associated with death resulting from IHD, whereas latent CD was not (HR, 0.71; 95% CI, 0.34 to 1.50).

CONCLUSIONS

Individuals with CD or small intestinal inflammation are at increased risk of incident IHD. We were unable to show a positive association between latent CD and incident IHD.

Authors+Show Affiliations

Department of Pediatrics, Örebro University Hospital, Örebro, Sweden. jonasludvigsson@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21262996

Citation

Ludvigsson, Jonas F., et al. "Nationwide Cohort Study of Risk of Ischemic Heart Disease in Patients With Celiac Disease." Circulation, vol. 123, no. 5, 2011, pp. 483-90.
Ludvigsson JF, James S, Askling J, et al. Nationwide cohort study of risk of ischemic heart disease in patients with celiac disease. Circulation. 2011;123(5):483-90.
Ludvigsson, J. F., James, S., Askling, J., Stenestrand, U., & Ingelsson, E. (2011). Nationwide cohort study of risk of ischemic heart disease in patients with celiac disease. Circulation, 123(5), pp. 483-90. doi:10.1161/CIRCULATIONAHA.110.965624.
Ludvigsson JF, et al. Nationwide Cohort Study of Risk of Ischemic Heart Disease in Patients With Celiac Disease. Circulation. 2011 Feb 8;123(5):483-90. PubMed PMID: 21262996.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Nationwide cohort study of risk of ischemic heart disease in patients with celiac disease. AU - Ludvigsson,Jonas F, AU - James,Stefan, AU - Askling,Johan, AU - Stenestrand,Ulf, AU - Ingelsson,Erik, Y1 - 2011/01/24/ PY - 2011/1/26/entrez PY - 2011/1/26/pubmed PY - 2011/4/8/medline SP - 483 EP - 90 JF - Circulation JO - Circulation VL - 123 IS - 5 N2 - BACKGROUND: Studies on ischemic heart disease (IHD) incidence in individuals with celiac disease (CD) are contradictory and do not take small intestinal pathology into account. METHODS AND RESULTS: In this Swedish population-based cohort study, we examined the risk of IHD in patients with CD based on small intestinal histopathology. We defined IHD as death or incident disease in myocardial infarction or angina pectoris in Swedish national registers. In 2006 to 2008, we collected duodenal/jejunal biopsy data on CD (equal to villous atrophy; Marsh 3; n=28 190 unique individuals) and inflammation without villous atrophy (Marsh 1 to 2; n=12 598) from all 28 pathology departments in Sweden. A third cohort consisted of 3658 individuals with normal mucosa but positive CD serology (Marsh 0, latent CD). We found an increased risk of incident IHD in patients undergoing small intestinal biopsy that was independent of small intestinal histopathology (CD: hazard ratio [HR], 1.19; 95% confidence interval [CI], 1.11 to 1.28; 991 events; inflammation: HR, 1.28; 95% CI, 1.19 to 1.39; 809 events; and latent CD: HR, 1.14; 95% CI, 0.87 to 1.50; 62 events). Celiac disease (HR, 1.22; 95% CI, 1.06 to 1.40) and inflammation (HR, 1.32; 95% CI, 1.14 to 1.52) were both associated with death resulting from IHD, whereas latent CD was not (HR, 0.71; 95% CI, 0.34 to 1.50). CONCLUSIONS: Individuals with CD or small intestinal inflammation are at increased risk of incident IHD. We were unable to show a positive association between latent CD and incident IHD. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/21262996/Nationwide_cohort_study_of_risk_of_ischemic_heart_disease_in_patients_with_celiac_disease_ L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.110.965624?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -