Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure: a Danish Nationwide Cohort A Danish Nationwide Cohort Study

Søren Lund Kristensen; Ole Ahlehoff; Jesper Lindhardsen; Rune Erichsen; Morten Lamberts; Usman Khalid; Ole Haagen Nielsen; Christian Torp-Pedersen; Gunnar Hilmar Gislason; Peter Riis Hansen

doi:10.1161/CIRCHEARTFAILURE.114.001152

Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure: a Danish Nationwide Cohort A Danish Nationwide Cohort Study

Søren Lund Kristensen, Ole Ahlehoff, Jesper Lindhardsen, Rune Erichsen, Morten Lamberts, Usman Khalid, Ole Haagen Nielsen, Christian Torp-Pedersen, Gunnar Hilmar Gislason, Peter Riis Hansen

Department of Clinical Medicine

31 Citations (Scopus)

Abstract

BACKGROUND: Inflammatory bowel disease (IBD) has been linked to adverse cardiovascular events, but a relation to heart failure (HF) is uncertain. We investigated the IBD-associated risk of HF in a nationwide setting.

METHODS AND RESULTS: A total of 5 436 647 Danish citizens, with no history of IBD or HF, were included on January 1, 1997, and followed up until first hospitalization for HF, death, or December 31, 2011. Of these subjects, 23 681 developed IBD for which disease activity was determined continuously throughout the study. The risk of hospitalization for HF was estimated with a Poisson regression model adjusting for comorbidity and cardiovascular pharmacotherapy as time-dependent covariates. During a mean follow-up of 11.8 years in the reference population and 6.4 years in the IBD group, hospitalization for HF occurred in 553 subjects with IBD and 171 405 in the reference population. Patients with IBD had a 37% increased risk of hospitalization for HF (incidence rate ratio, 1.37; 95% confidence interval, 1.26-1.49) compared with the reference population. IBD activity-specific analyses showed markedly increased risk of HF hospitalization during flares (incidence rate ratio, 2.54; 95% confidence interval, 2.13-3.04) and persistent activity (incidence rate ratio, 2.73; 95% confidence interval, 2.25-3.33) but not in IBD remission (incidence rate ratio, 1.04; 95% confidence interval, 0.94-1.16).

CONCLUSIONS: In a nationwide cohort, IBD was associated with an increased risk of hospitalization for HF, and this risk was strongly correlated to periods of active disease. The mechanisms underlying this finding warrant further studies.

Original language	English
Journal	Circulation: Heart Failure
Volume	7
Issue number	5
Pages (from-to)	717-722
Number of pages	6
ISSN	1941-3289
DOIs	https://doi.org/10.1161/CIRCHEARTFAILURE.114.001152
Publication status	Published - Sept 2014

Keywords

Adult
Comorbidity
Confidence Intervals
Denmark
Female
Follow-Up Studies
Heart Failure
Hospitalization
Humans
Incidence
Inflammatory Bowel Diseases
Male
Retrospective Studies
Risk Factors
Severity of Illness Index
Survival Rate
Time Factors

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10.1161/CIRCHEARTFAILURE.114.001152

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Kristensen, S. L., Ahlehoff, O., Lindhardsen, J., Erichsen, R., Lamberts, M., Khalid, U., Nielsen, O. H., Torp-Pedersen, C., Gislason, G. H., & Hansen, P. R. (2014). Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure: a Danish Nationwide Cohort A Danish Nationwide Cohort Study . Circulation: Heart Failure, 7(5), 717-722. https://doi.org/10.1161/CIRCHEARTFAILURE.114.001152

Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure : a Danish Nationwide Cohort A Danish Nationwide Cohort Study . / Kristensen, Søren Lund; Ahlehoff, Ole; Lindhardsen, Jesper et al.

In: Circulation: Heart Failure, Vol. 7, No. 5, 09.2014, p. 717-722.

Research output: Contribution to journal › Journal article › Research › peer-review

Kristensen, SL, Ahlehoff, O, Lindhardsen, J, Erichsen, R, Lamberts, M, Khalid, U, Nielsen, OH, Torp-Pedersen, C, Gislason, GH & Hansen, PR 2014, 'Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure: a Danish Nationwide Cohort A Danish Nationwide Cohort Study ', Circulation: Heart Failure, vol. 7, no. 5, pp. 717-722. https://doi.org/10.1161/CIRCHEARTFAILURE.114.001152

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title = "Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure: a Danish Nationwide Cohort A Danish Nationwide Cohort Study ",

abstract = "BACKGROUND: Inflammatory bowel disease (IBD) has been linked to adverse cardiovascular events, but a relation to heart failure (HF) is uncertain. We investigated the IBD-associated risk of HF in a nationwide setting.METHODS AND RESULTS: A total of 5 436 647 Danish citizens, with no history of IBD or HF, were included on January 1, 1997, and followed up until first hospitalization for HF, death, or December 31, 2011. Of these subjects, 23 681 developed IBD for which disease activity was determined continuously throughout the study. The risk of hospitalization for HF was estimated with a Poisson regression model adjusting for comorbidity and cardiovascular pharmacotherapy as time-dependent covariates. During a mean follow-up of 11.8 years in the reference population and 6.4 years in the IBD group, hospitalization for HF occurred in 553 subjects with IBD and 171 405 in the reference population. Patients with IBD had a 37% increased risk of hospitalization for HF (incidence rate ratio, 1.37; 95% confidence interval, 1.26-1.49) compared with the reference population. IBD activity-specific analyses showed markedly increased risk of HF hospitalization during flares (incidence rate ratio, 2.54; 95% confidence interval, 2.13-3.04) and persistent activity (incidence rate ratio, 2.73; 95% confidence interval, 2.25-3.33) but not in IBD remission (incidence rate ratio, 1.04; 95% confidence interval, 0.94-1.16).CONCLUSIONS: In a nationwide cohort, IBD was associated with an increased risk of hospitalization for HF, and this risk was strongly correlated to periods of active disease. The mechanisms underlying this finding warrant further studies.",

keywords = "Adult, Comorbidity, Confidence Intervals, Denmark, Female, Follow-Up Studies, Heart Failure, Hospitalization, Humans, Incidence, Inflammatory Bowel Diseases, Male, Retrospective Studies, Risk Factors, Severity of Illness Index, Survival Rate, Time Factors",

author = "Kristensen, {S{\o}ren Lund} and Ole Ahlehoff and Jesper Lindhardsen and Rune Erichsen and Morten Lamberts and Usman Khalid and Nielsen, {Ole Haagen} and Christian Torp-Pedersen and Gislason, {Gunnar Hilmar} and Hansen, {Peter Riis}",

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year = "2014",

month = sep,

doi = "10.1161/CIRCHEARTFAILURE.114.001152",

language = "English",

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journal = "Circulation: Heart Failure",

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T1 - Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure

T2 - a Danish Nationwide Cohort A Danish Nationwide Cohort Study

AU - Kristensen, Søren Lund

AU - Ahlehoff, Ole

AU - Lindhardsen, Jesper

AU - Erichsen, Rune

AU - Lamberts, Morten

AU - Khalid, Usman

AU - Nielsen, Ole Haagen

AU - Torp-Pedersen, Christian

AU - Gislason, Gunnar Hilmar

AU - Hansen, Peter Riis

PY - 2014/9

Y1 - 2014/9

N2 - BACKGROUND: Inflammatory bowel disease (IBD) has been linked to adverse cardiovascular events, but a relation to heart failure (HF) is uncertain. We investigated the IBD-associated risk of HF in a nationwide setting.METHODS AND RESULTS: A total of 5 436 647 Danish citizens, with no history of IBD or HF, were included on January 1, 1997, and followed up until first hospitalization for HF, death, or December 31, 2011. Of these subjects, 23 681 developed IBD for which disease activity was determined continuously throughout the study. The risk of hospitalization for HF was estimated with a Poisson regression model adjusting for comorbidity and cardiovascular pharmacotherapy as time-dependent covariates. During a mean follow-up of 11.8 years in the reference population and 6.4 years in the IBD group, hospitalization for HF occurred in 553 subjects with IBD and 171 405 in the reference population. Patients with IBD had a 37% increased risk of hospitalization for HF (incidence rate ratio, 1.37; 95% confidence interval, 1.26-1.49) compared with the reference population. IBD activity-specific analyses showed markedly increased risk of HF hospitalization during flares (incidence rate ratio, 2.54; 95% confidence interval, 2.13-3.04) and persistent activity (incidence rate ratio, 2.73; 95% confidence interval, 2.25-3.33) but not in IBD remission (incidence rate ratio, 1.04; 95% confidence interval, 0.94-1.16).CONCLUSIONS: In a nationwide cohort, IBD was associated with an increased risk of hospitalization for HF, and this risk was strongly correlated to periods of active disease. The mechanisms underlying this finding warrant further studies.

AB - BACKGROUND: Inflammatory bowel disease (IBD) has been linked to adverse cardiovascular events, but a relation to heart failure (HF) is uncertain. We investigated the IBD-associated risk of HF in a nationwide setting.METHODS AND RESULTS: A total of 5 436 647 Danish citizens, with no history of IBD or HF, were included on January 1, 1997, and followed up until first hospitalization for HF, death, or December 31, 2011. Of these subjects, 23 681 developed IBD for which disease activity was determined continuously throughout the study. The risk of hospitalization for HF was estimated with a Poisson regression model adjusting for comorbidity and cardiovascular pharmacotherapy as time-dependent covariates. During a mean follow-up of 11.8 years in the reference population and 6.4 years in the IBD group, hospitalization for HF occurred in 553 subjects with IBD and 171 405 in the reference population. Patients with IBD had a 37% increased risk of hospitalization for HF (incidence rate ratio, 1.37; 95% confidence interval, 1.26-1.49) compared with the reference population. IBD activity-specific analyses showed markedly increased risk of HF hospitalization during flares (incidence rate ratio, 2.54; 95% confidence interval, 2.13-3.04) and persistent activity (incidence rate ratio, 2.73; 95% confidence interval, 2.25-3.33) but not in IBD remission (incidence rate ratio, 1.04; 95% confidence interval, 0.94-1.16).CONCLUSIONS: In a nationwide cohort, IBD was associated with an increased risk of hospitalization for HF, and this risk was strongly correlated to periods of active disease. The mechanisms underlying this finding warrant further studies.

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KW - Comorbidity

KW - Confidence Intervals

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KW - Female

KW - Follow-Up Studies

KW - Heart Failure

KW - Hospitalization

KW - Humans

KW - Incidence

KW - Inflammatory Bowel Diseases

KW - Male

KW - Retrospective Studies

KW - Risk Factors

KW - Severity of Illness Index

KW - Survival Rate

KW - Time Factors

U2 - 10.1161/CIRCHEARTFAILURE.114.001152

DO - 10.1161/CIRCHEARTFAILURE.114.001152

M3 - Journal article

C2 - 25052190

SN - 1941-3289

VL - 7

SP - 717

EP - 722

JO - Circulation: Heart Failure

JF - Circulation: Heart Failure

IS - 5

ER -

Inflammatory Bowel Disease Is Associated With an Increased Risk of Hospitalization for Heart Failure: a Danish Nationwide Cohort A Danish Nationwide Cohort Study

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Keywords

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