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The characterisation and risk factors of ischaemic heart disease in patients with coeliac disease.
Aliment Pharmacol Ther. 2013 May; 37(9):905-14.AP

Abstract

BACKGROUND

Studies have shown an increased risk of ischaemic heart disease (IHD) in patients with coeliac disease (CD), despite the patients' lack of traditional IHD risk factors.

AIM

To characterise IHD according to CD status.

METHODS

Data on duodenal or jejunal biopsies were collected in 2006-2008 from all 28 pathology departments in Sweden and were used to define CD (equal to villous atrophy; Marsh stage 3). We used the Swedish cardiac care register SWEDEHEART to identify IHD and to obtain data on clinical status and risk factors at time of first myocardial infarction for this case-only comparison. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). CD patients were compared with general population reference individuals.

RESULTS

We identified 1075 CD patients and 4142 reference individuals with subsequent IHD. CD patients with myocardial infarction had lower body mass index (P < 0.001) and cholesterol values (P < 0.001) and were less likely to be active smokers (OR = 0.74; 95% CI = 0.56-0.98) than reference individuals with myocardial infarction. CD patients had less extensive coronary artery disease at angiography (any stenosis: OR = 0.80; 95% CI = 0.66-0.97; three-vessel disease: OR = 0.73; 95% CI = 0.57-0.94); but there was no difference in the proportions of CD patients with positive biochemical markers of myocardial infarction (CD: 92.2% vs. reference individuals: 91.5%, P = 0.766).

CONCLUSION

Despite evidence of an increased risk of IHD and higher cardiovascular mortality, patients with coeliac disease with IHD have a more favourable cardiac risk profile compared with IHD in reference individuals.

Authors+Show Affiliations

Vårdcentralen Värmlands Nysäter, Värmland County, Sweden. lojsankik@hotmail.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

23451861

Citation

Emilsson, L, et al. "The Characterisation and Risk Factors of Ischaemic Heart Disease in Patients With Coeliac Disease." Alimentary Pharmacology & Therapeutics, vol. 37, no. 9, 2013, pp. 905-14.
Emilsson L, Carlsson R, Holmqvist M, et al. The characterisation and risk factors of ischaemic heart disease in patients with coeliac disease. Aliment Pharmacol Ther. 2013;37(9):905-14.
Emilsson, L., Carlsson, R., Holmqvist, M., James, S., & Ludvigsson, J. F. (2013). The characterisation and risk factors of ischaemic heart disease in patients with coeliac disease. Alimentary Pharmacology & Therapeutics, 37(9), 905-14. https://doi.org/10.1111/apt.12271
Emilsson L, et al. The Characterisation and Risk Factors of Ischaemic Heart Disease in Patients With Coeliac Disease. Aliment Pharmacol Ther. 2013;37(9):905-14. PubMed PMID: 23451861.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The characterisation and risk factors of ischaemic heart disease in patients with coeliac disease. AU - Emilsson,L, AU - Carlsson,R, AU - Holmqvist,M, AU - James,S, AU - Ludvigsson,J F, Y1 - 2013/03/04/ PY - 2012/12/17/received PY - 2013/01/15/revised PY - 2013/01/30/revised PY - 2013/02/11/accepted PY - 2013/3/5/entrez PY - 2013/3/5/pubmed PY - 2013/9/18/medline SP - 905 EP - 14 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 37 IS - 9 N2 - BACKGROUND: Studies have shown an increased risk of ischaemic heart disease (IHD) in patients with coeliac disease (CD), despite the patients' lack of traditional IHD risk factors. AIM: To characterise IHD according to CD status. METHODS: Data on duodenal or jejunal biopsies were collected in 2006-2008 from all 28 pathology departments in Sweden and were used to define CD (equal to villous atrophy; Marsh stage 3). We used the Swedish cardiac care register SWEDEHEART to identify IHD and to obtain data on clinical status and risk factors at time of first myocardial infarction for this case-only comparison. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). CD patients were compared with general population reference individuals. RESULTS: We identified 1075 CD patients and 4142 reference individuals with subsequent IHD. CD patients with myocardial infarction had lower body mass index (P < 0.001) and cholesterol values (P < 0.001) and were less likely to be active smokers (OR = 0.74; 95% CI = 0.56-0.98) than reference individuals with myocardial infarction. CD patients had less extensive coronary artery disease at angiography (any stenosis: OR = 0.80; 95% CI = 0.66-0.97; three-vessel disease: OR = 0.73; 95% CI = 0.57-0.94); but there was no difference in the proportions of CD patients with positive biochemical markers of myocardial infarction (CD: 92.2% vs. reference individuals: 91.5%, P = 0.766). CONCLUSION: Despite evidence of an increased risk of IHD and higher cardiovascular mortality, patients with coeliac disease with IHD have a more favourable cardiac risk profile compared with IHD in reference individuals. SN - 1365-2036 UR - https://www.unboundmedicine.com/medline/citation/23451861/The_characterisation_and_risk_factors_of_ischaemic_heart_disease_in_patients_with_coeliac_disease_ L2 - https://doi.org/10.1111/apt.12271 DB - PRIME DP - Unbound Medicine ER -