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Follow-up of ischaemic heart disease in patients with coeliac disease
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Cardiology.
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2015 (English)In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 22, no 1, 83-90 p.Article in journal (Refereed) Published
Abstract [en]

Patients with coeliac disease and myocardial infarction have a more favourable atherosclerotic risk factor profile than controls with myocardial infarction (MI). Therefore, MI prognosis and treatment may differ according to coeliac status. This paper reports on the study of Swedish MI patients with and without coeliac disease (equal to villous atrophy; Marsh histopathology stage 3) based on duodenal or jejunal biopsy data. We used the Swedish Quality Register (SWEDEHEART) to identify individuals with a record of MI from 2005 to 2008 and to obtain data on medication, coronary interventions, and clinical and laboratory parameters at 6-10 weeks and one year after first MI. One-year mortality and coronary interventions were assessed for 430 coeliac patients and 1988 controls. For other outcome variables, we compared 42 coeliac patients with MI and 201 general population controls with MI. Odds ratios (ORs) were calculated by logistic regression. The results showed that compared with controls with MI, coeliac individuals with MI had significantly higher one-year all-cause mortality (OR=1.43; 95% confidence interval (CI)=1.04-1.95) but less often underwent a percutaneous coronary intervention (OR=0.77; 95% CI=0.61-0.96). Coeliac patients were more often prescribed warfarin but less often aspirin and statins. The readmission rate due to cardiac events in coeliac patients was 15.2% vs. 12.6% in controls (p-value=0.69). Other clinical and laboratory parameters were similar. We conclude that the follow up of MI does not seem to differ between coeliac patients and controls, and is unlikely to explain the excess mortality from cardiovascular disease noted in Swedish patients with CD.

Place, publisher, year, edition, pages
2015. Vol. 22, no 1, 83-90 p.
Keyword [en]
Autoimmunity, coeliac, inflammation, risk factors, myocardial infarction
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:uu:diva-241942DOI: 10.1177/2047487313502446ISI: 000346557500007OAI: oai:DiVA.org:uu-241942DiVA: diva2:782239
Available from: 2015-01-20 Created: 2015-01-19 Last updated: 2015-01-20Bibliographically approved

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James, Stefan
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