S1844 Racial and Socioeconomic Disparities in Coronary Artery Disease Prevalence Among Hospitalized Patients With Inflammatory Bowel Disease

Introduction: Racial and socioeconomic disparities are well-documented in both cardiovascular disease and inflammatory bowel disease (IBD), yet their intersection remains underexplored. This study examines how the prevalence of coronary artery disease (CAD) varies by race and household income among hospitalized patients with IBD, utilizing a national database. Methods: We analyzed 4,142,365 IBD-related hospitalizations from the National Inpatient Sample (2016–2019), stratifying patients by CAD status. Race categories included White, Black, Hispanic, Asian/Pacific Islander, Native American, and Other. Socioeconomic status was assessed by national median household income quartile (0–25th, 26–50th, 51–75th, 76–100th). Proportional differences were described. Results: Among patients with IBD and concomitant CAD (n = 842,658), 76.9% were White (n = 647,850), compared to 70.3% of those without CAD (n = 2,318,442). Black patients comprised 11.6% (n = 97,747) of the CAD group as compared to 14.7% (n = 485,062) of the non-CAD group. Hispanic patients made up 6.9% (n = 58,144) of the CAD group vs 9.6% (n = 316,772) in the non-CAD group. Similarly, Asian/Pacific Islander patients made up 1.8% of the CAD group vs 2.2% of the non-CAD group, while Native American patients made up 0.4% of the CAD group vs 0.5% of the non-CAD group. By income, 29.5% (n = 248,584) the patients with CAD were from the lowest income quartile (0–25th) compared to 28.5% (n = 940,416) of non-CAD patients. Only 19.9% (n = 167,689) of CAD patients were from the highest income quartile (76–100th), as compared to 21.4% (n = 706,137) of non-CAD patients. Conclusion: CAD among hospitalized patients with IBD is disproportionately prevalent in White patients and those from lower-income quartiles. These disparities may reflect unequal access to preventive care, cumulative exposure to social determinants of health, structural barriers to early cardiovascular risk management, and genetic predisposition. Our findings highlight the need for equity-focused interventions to reduce cardiovascular risk in underrepresented IBD populations. Improved access to preventive care and socioeconomic support may help close these gaps in cardiovascular outcomes among patients with IBD.