Evidence mapPaperPMID 41131885Full record

ArticleJournal of internal medicine2025

Association of histologic and clinical activity with major adverse cardiovascular events in patients with inflammatory bowel disease: A cohort study.

Jiangwei Sun, Karl Mårild, Johan Sundström, David Bergman, SWIBREG Study Group, Fahim Ebrahimi, Jonas Halfvarson, Ola Olén, Jonas F Ludvigsson

Abstract read
In one paragraph

Article in Journal of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jiangwei SunDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Karl MårildDepartment of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
Johan SundströmDepartment of Medical Sciences, Uppsala University, Uppsala, Sweden.
David BergmanDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
SWIBREG Study Group
Fahim EbrahimiDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Jonas HalfvarsonDepartment of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Ola OlénDivision of Clinical Epidemiology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden.
Jonas F LudvigssonDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Funding

European Crohn's and Colitis OrganizationHjärt-LungfondenKarolinska InstitutetRuth och Richard Julins StiftelseStiftelsen Professor Nanna Svartz FondSvenska LäkaresällskapetSvenska Sällskapet för Medicinsk Forskning
6 · The paper itself

Abstract

objectivesInflammatory bowel disease (IBD) is a chronic disorder linked to cardiovascular disease (CVD). However, the impact of histologic and clinical activity on this association remains unclear.

methodsWe conducted a nationwide cohort study in Sweden involving 59,168 IBD patients diagnosed in 1969-2017 with histologic evaluation and 91,800 patients diagnosed in 1969-2020 with assessment of clinical activity in 2006-2021. The primary outcome was incident major adverse cardiovascular events (MACE), a composite outcome encompassing ischemic heart disease, stroke, and heart failure. Cox proportional hazards model estimated adjusted hazard ratios (aHRs) of MACE and its subcomponents.

resultsWe found an increased MACE risk following histologic inflammation (n = 868, incidence rate [IR]: 86.3/10,000 person-years) compared to remission (n = 558, IR = 71.3) (aHR = 1.16 [1.04-1.30]). This excess risk was evident in Crohn's disease (aHR = 1.30 [1.03-1.64]) and ulcerative colitis (aHR = 1.13 [1.01-1.27]). Histologic inflammation was associated with an increased risk of ischemic heart disease, myocardial infarction, ischemic stroke, and heart failure, but not with hemorrhagic stroke. Compared to clinically quiescent IBD, active IBD was associated with an increased MACE risk (IR: 131.4 vs. 93.7; aHR = 1.54 [1.46-1.63]) and all MACE subcomponents. In patients with clinically quiescent IBD, histologic inflammation remained linked to myocardial infarction (aHR = 1.29 [1.06-1.58]) and heart failure (aHR = 1.19 [1.00-1.43]).

conclusionBoth histologic and clinical activities of IBD were associated with an increased MACE risk, suggesting that improved disease control may reduce MACE risk in IBD.

Indexed as

Cardiovascular DiseasesInflammatory Bowel DiseasesAdultAgedCohort StudiesColitis, UlcerativeCrohn DiseaseFemaleHumansIncidenceMaleMiddle AgedProportional Hazards ModelsRisk FactorsSwedenclinical activitycohorthistologic remissioninflammatory bowel diseaseMACE

Identifiers

PMID41131885
PMCPMC12617494

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.