S1735 Coronary Artery Disease in Inflammatory Bowel Disease Patients: Are There Outcome Disparities Between Ulcerative Colitis and Crohn's Disease?

Introduction: IBD, including Crohn’s Disease (CD) and Ulcerative Colitis (UC), has previously been associated with an increased cardiovascular risk. While emerging evidence links IBD to coronary artery disease (CAD), the impact of IBD subtypes on outcomes following CAD admissions remains poorly understood. This study examines the outcomes of CAD admissions in patients with CD and UC and evaluates whether IBD serves as a risk factor for adverse outcomes. Methods: A retrospective cohort study using the National Inpatient Sample (2016–2021) analyzed patients with IBD admitted for a primary diagnosis of CAD. Outcomes were compared between Crohn’s disease (CD) and ulcerative colitis (UC), adjusting for confounders. We also evaluated IBD as an overall risk factor for adverse CAD outcomes. Statistical analysis included t-tests and linear and logistic regression, with significance set at P < 0.05. We used odds ratios (ORs) to assess risk and performed analyses using STATA 18. Results: We analyzed 135,785 patients with CD and 97,665 with UC, totaling 233,450 IBD patients admitted with a primary diagnosis of CAD. Among IBD patients admitted for CAD, UC was associated with a significantly higher risk of death (OR 1.20, P < 0.01), whereas CD was linked to a lower risk (OR 0.83, P < 0.01). UC patients had greater odds of bleeding requiring blood transfusions, while CD patients demonstrated a reduced risk for these complications. IBD patients as a group had increased risks of acute kidney injury, pulmonary embolism, and sepsis, as well as significantly higher odds of intestinal complications, including intestinal perforation, small bowel obstruction, ileus, and gastrointestinal bleeding. Portal vein thrombosis was notably a common complication in IBD patients. Furthermore, UC patients experienced longer hospital stays by 0.1 days (P < 0.05) and incurred higher hospital charges by $7,377 (P < 0.01). Conclusion: IBD patients have an elevated risk of complications following admission for CAD. UC patients experience worse cardiovascular and gastrointestinal outcomes compared to those with CD, including notably higher odds of mortality. Among the study’s limitations is the inability to classify disease severity or determine whether patients were on advanced IBD therapies, factors that may meaningfully influence outcomes. Further studies are needed to investigate the mechanisms underlying these disparities and address the limitations of our current study.