C0640 - Cardiovascular Diseases in Celiac Disease Patients

Monday, October 24, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Maryam Haider, MD

Wayne State University/Detroit Medical Center Sinai Grace Hospital
Detroit, MI

Maryam Haider, MD¹, Rawan Aljaras, MD², Iana Gueorguieva, MD³
¹Wayne State University/Detroit Medical Center Sinai Grace Hospital, Detroit, MI; ²Indiana University School of Medicine, Indianapolis, IN; ³Ascension Providence Hospital/Michigan State University College of Human Medicine, Southfield, MI

Introduction: Celiac disease (CD) is a common immune-mediated disease of the small bowel caused by exposure to gluten in genetically sensitive individuals. CD is associated with a modestly increased risk of cardiovascular diseases, but the evidence base is limited. In this study, we aimed to analyze the prevalence of cardiovascular diseases in CD patients.

Methods: NIS database was queried from September 2015 to 2019 to retrieve records of patients admitted with a principal or secondary diagnosis of CD. We compared the incidence of cardiovascular diseases in CD (cases) to patients who did not have CD(controls). Controls were 1:1 fixed ratio nearest neighbor (greedy) propensity score-matched using the patient’s age, sex, and race. We used clinical classification software refined (CCSR) for ICD-10-CM diagnosis v2021 and identified a spectrum of cardiovascular diseases. We used the Rao-Scott chi-square test on the weighted sample. We used alpha = 0.01 and P value < 0.001 considered statistically significant. Statistical analysis is performed in R (Studio 1.4).

Results: A total of 178,590 records identified with CD in the weighted sample. Compared to non-CD matched patients, CD patients have an increased prevalence some cardiovascular diseases including cardiac and circulatory congenital anomalies (OR, 2.34; 99% CI, 1.83 – 3.01; p < 0.001), vasculitis (OR, 2.39; 99% CI, 1.66 – 3.43; p < 0.001), acute hemorrhagic cerebrovascular disease (OR, 1.98; 99% CI, 1.42 – 2.75; p < 0.001), chronic phlebitis (OR, 1.87; 99% CI, 1.26 – 2.76; p < 0.001), peripheral and visceral vascular disease (OR, 1.71; 99% CI, 1.55 – 1.89; p < 0.001), pericarditis and pericardial disease (OR, 1.70; 99% CI, 1.29 – 2.24; p < 0.001), chronic rheumatic heart disease (OR, 1.48; 99% CI, 1.25 – 1.76; p < 0.001, hypotension (OR, 1.50; 99% CI, 1.37 – 1.65; p < 0.001), acute phlebitis (OR, 1.48; 99% CI, 1.27 – 1.73; p < 0.001), conduction disorders (OR, 1.32; 99% CI, 1.20 – 1.45; p < 0.001), and cardiac dysrhythmias (OR, 1.13; 99% CI, 1.06 – 1.20; p < 0.001). CD patients are at low risk of essential hypertension (OR, 0.89; 95% CI, 0.85 – 0.94; p < 0.001) and heart failure (OR, 0.78; 95% CI, 0.73 – 0.84; p < 0.001).

Discussion: Our study showed that CD patients are an increased likelihood of some cardiovascular diseases, however little is known about the risk factors and pathogenesis. Therefore, more studies are needed to determine the risk factor and mechanisms for developing cardiovascular diseases in CD patients.

Variables	CD = No (n= 178584) 50%	CD = Yes (n= 178590) 50%	OR (99%CI)	P value
Cardiac and circulatory congenital anomalies	819 (0.46%)	1915 (1.07%)	2.34 (1.83 – 3.01)	< .0001
Chronic rheumatic heart disease	2300 (1.29%)	3385 (1.89%)	1.48 (1.25 – 1.76)	< .0001
Endocarditis and endocardial disease	460 (0.26%)	515 (0.29%)	NA	0.4468
Myocarditis and cardiomyopathy	5525 (3.10%)	6410 (3.59%)	1.17 (1.04 – 1.31)	0.0008
Pericarditis and pericardial disease	745 (0.42%)	1265 (0.71%)	1.70 (1.29 – 2.24)	< .0001
Essential hypertension	57753 (32.3%)	53330 (29.9%)	0.89 (0.85 – 0.94)	< .0001
Acute myocardial infarction	4465 (2.50%)	4135 (2.32%)	NA	0.1410
Coronary atherosclerosis and other heart disease	28964 (16.2%)	29915 (16.8%)	NA	0.1196
Acute pulmonary embolism	1905 (1.07%)	1909 (1.08%)	NA	0.8876
Pulmonary heart disease	4800 (2.69%)	5605 (3.14%)	1.17 (1.04 – 1.33)	0.0008
Conduction disorders	7445 (4.17%)	9710 (5.43%)	1.32 (1.20 – 1.45)	< .0001
Cardiac dysrhythmias	24389 (13.7%)	26990 (15.1%)	1.13 (1.06 – 1.20)	< .0001
Cardiac arrest and ventricular fibrillation	864 (0.48%)	685 (0.38%)	NA	0.0383
Heart failure	24919 (14.0%)	20100 (11.3%)	0.78 (0.73 – 0.84)	< .0001
Cerebral infarction	2825 (1.58%)	2725 (1.53%)	NA	0.5653
Acute hemorrhagic cerebrovascular disease	450 (0.25%)	890 (0.49%)	1.98 (1.42 – 2.75)	< .0001
Occlusion or stenosis of precerebral or cerebral arteries without infarction	1490 (0.83%)	2025 (1.14%)	1.36 (1.10 – 1.68)	0.0001
Peripheral and visceral vascular disease	6610 (3.70%)	11045 (6.19%)	1.71 (1.55 – 1.89)	< .0001
Hypotension	7470 (4.19%)	10975 (6.14%)	1.50 (1.37 – 1.65)	< .0001
Acute phlebitis; thrombophlebitis and thromboembolism	2435 (1.36%)	3580 (2.00%)	1.48 (1.27 – 1.73)	< .0001
Chronic phlebitis; thrombophlebitis and thromboembolism	625 (0.19 %)	335 (0.35%)	1.87 (1.26 – 2.76)	< .0001
Vasculitis	365 (0.20 %)	870 (0.49%)	2.39 (1.66 – 3.43)	< .0001

Table: Prevalence of Cardiovascular Diseases in CD vs age-, sex-, race- matched non-CD patients, Weighted NIS 2015Q4 to 2019.

Disclosures:

Maryam Haider indicated no relevant financial relationships.

Rawan Aljaras indicated no relevant financial relationships.

Iana Gueorguieva indicated no relevant financial relationships.

Maryam Haider, MD¹, Rawan Aljaras, MD², Iana Gueorguieva, MD³. C0640 - Cardiovascular Diseases in Celiac Disease Patients, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.