S1625 Sex Differences in Cardiovascular and Venous Thromboembolic Complications in Inflammatory Bowel Disease: A Large Multicenter Study

Introduction: Inflammatory bowel disease (IBD) is a chronic inflammatory condition that affects organs beyond the gastrointestinal tract. Emerging evidence shows an increased risk of cardiovascular disease (CVD) and venous thromboembolism (VTE), despite not having traditional CVD risk factors. It is unclear if there are sex-disparities in risks of CVD and VTE in IBD. This study aims to assess the sex-disparities in rates and outcomes of CVD and VTE in patients with IBD. Methods: This is a retrospective study that was conducted through TriNetX, a global research network that provides access to multi-institutional databases. We included all patients ≥18 years of age with a confirmed diagnosis of IBD between January 1, 2015 and January 1, 2025. Our data was split into female and male cohorts. Propensity score matching (PSM) was performed on demographics, age, relevant medications and CVD/VTE risk factors. Outcomes of interest included myocardial infarction (MI), heart failure, cerebral infarctions, deep vein thrombosis (DVT) and pulmonary embolism (PE). Results: After PSM, a total of 532,720 patients were included: Female Cohort (n = 266,360), and Male Cohort (n = 266,360). Mean follow up time in the female cohort was 187.9 ± 161.5 weeks and 179.5 ± 160.4 in the male cohort. Female patients with IBD had a lower risk of developing DVT [odds ratio (OR) 0.927; 95% confidence interval (CI) 0.895-0.960), P < 0.001]. Risks of developing MI (OR 0.803; 95% CI 0.777-0.831, P < 0.001) and heart failure (OR 0.914; 95% CI 0.895-0.934, P < 0.001) were lower in female compared to male patients with IBD. There were no significant differences between the 2 groups in terms of risk of acute PE and cerebrovascular. Conclusion: The risks of DVT, MI and heart failure were higher in male patients compared to female patients with IBD in our study. There were non-significant trends for higher risk of PE and cerebrovascular in female patients compared to male patient with IBD. The mechanisms behind this sex disparities in CVD and VTE complications in IBD remain unclear and warrant further investigation.