P0240 - Microscopic Colitis is Associated With a Higher Risk of Adverse Cardiovascular Outcomes: Findings From a Multi-Institutional Research Network Analysis

Soban Maan, MD, Shailendra Singh, MD, Shyam Thakkar, MD
West Virginia University, Morgantown, WV

Introduction: Studies have shown elevated cardiovascular event risk in patients with inflammatory diseases of the bowel. However, evidence regarding cardiovascular risk in microscopic colitis (MC) is limited. Currently, the only US data come from a single-center study involving 269 patients without adjustment for confounding.¹

Methods: We conducted a population-based, retrospective cohort study using TriNetX, a multi-institutional research network. Those with a history of cardiovascular disease (CVD) prior to initiation of follow-up were excluded. Patients diagnosed with MC between January 1, 2006 and December 31, 2022 (MC group) were matched with patients without MC (control group) using 1:1 propensity score matching (PSM) to adjust for potential confounders (Table 1). The primary outcome was CVD, a composite of incident heart failure (HF), coronary artery disease (CAD), and cerebrovascular disease. These components of the primary composite outcome were also assessed separately as secondary outcomes. Hazard ratio (HRs) and 95% confidence intervals (CIs) were computed using the Cox proportional hazards model. Sensitivity analysis was performed after excluding patients with outcomes within 1 year after onset of follow-up (to reduce bias resulting from pre-existing CVD).

Results: Each cohort included 30,680 patients following PSM. The cohorts were well matched after PSM (standardized mean difference ≤ 0.1 for all covariates) (Table 1). Mean (SD) follow-up duration was 4 (2.9) years for the MC cohort and 11.6 (5.8) years for the control cohort. A significantly higher risk of the primary composite CVD outcome (HR: 1.272, 95% CI: 1.212, 1.336, Log rank p: < 0.001), incident HF (HR: 1.164, 95% CI: 1.089,1.243, Log rank p: < 0.001), CAD (HR: 1.544, 95% CI: 1.407,1.693, Log rank p: < 0.001), and cerebrovascular disease (HR: 1.39, 95% CI: 1.29,1.5, Log rank p: < 0.001) was observed in the MC group compared with the control group. These findings were robust in the sensitivity analysis.

Discussion: In the largest study to date on cardiovascular risk in MC, we found a higher risk of adverse cardiovascular outcomes in patients with MC compared with matched controls. This observed association warrants exploration in further studies.


References

1. Hong P, Krawczyk K, Awan RU, et al. Prevalence of Atherosclerotic Disease in Microscopic Colitis Patients. Gastro Hep Advances.
2023;2(7):971-978. doi:10.1016/j.gastha.2023.07.002


Disclosures:


Soban Maan, MD, Shailendra Singh, MD, Shyam Thakkar, MD. P0240 - Microscopic Colitis is Associated With a Higher Risk of Adverse Cardiovascular Outcomes: Findings From a Multi-Institutional Research Network Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.