Inflammatory Bowel Disease and Risk of Ischemic Heart Disease: An Updated Meta-Analysis of Cohort Studies.

BACKGROUND: Several immune-mediated diseases have been shown to be associated with an increased risk of cardiovascular disease. However, studies evaluating the association between inflammatory bowel disease and risk of cardiovascular disease reported inconsistent results. We assessed the association between inflammatory bowel disease and risk of ischemic heart disease in a meta-analysis of cohort studies. METHODS AND RESULTS: We conducted a literature search of PubMed and Embase up to October 2016 to identify relevant studies. The summary relative risks were calculated using the random-effects models. To explore the source of heterogeneity, we performed subgroup and sensitivity analysis. We included 10 cohort studies that satisfied our inclusion criteria. Patients with inflammatory bowel disease were associated with an increased risk of ischemic heart disease (relative risk: 1.244; 95% CI, 1.142-1.355). Considerable heterogeneity was observed. Crohn's disease showed a significantly increased risk of ischemic heart disease (relative risk=1.243; 95% CI, 1.042-1.482) and a positive association was also observed in ulcerative colitis (relative risk=1.206; 95% CI, 1.170-1.242). CONCLUSIONS: Based on meta-analysis of cohort studies, we found an increased risk of ischemic heart disease in patients with inflammatory bowel disease. Large long-term prospective studies are warranted to confirm our results.