Predictors of Coronary Artery Disease Severity in Patients with Inflammatory Bowel Disease: A Case-Control Study

Abstract

Objectives: This study aimed to identify risk factors that may predict the severity of coronary artery disease (CAD) among patients with inflammatory bowel disease (IBD). Methodology: A case-control study was conducted on 110 participants, comprising 55 patients with IBD and 55 healthy controls. Cardiovascular risk was evaluated using the Framingham risk score, carotid intima-media thickness (CIMT), and coronary angiography quantified by the SYNTAX score. CAD severity was categorized as low (SYNTAX ≤22) or moderate-to-high (SYNTAX >22). Results: Patients with IBD exhibited significantly higher leukocyte counts, fasting blood glucose, C-reactive protein (CRP), CIMT, and SYNTAX scores compared to controls (p<0.05). Atherosclerotic plaques were also more prevalent in the IBD group (21.8% vs. 3.6%). Among participants with SYNTAX >22, age, diabetes mellitus (DM), hypertension (HTN), smoking, and IBD prevalence were significantly higher. Multivariate logistic regression identified DM (OR=5.26, p=0.022), HTN (OR=3.89, p=0.026), smoking (OR=4.52, p=0.024), and IBD (OR=2.77, p<0.001) as independent predictors of severe CAD. Conclusion: IBD is significantly associated with more severe CAD, reflected in higher SYNTAX scores and CIMT values, independent of traditional cardiovascular risk factors. These findings highlight the importance of incorporating chronic inflammation markers into cardiovascular risk assessment models for IBD patients.