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Stroke Risk Up for Patients With Inflammatory Bowel Disease

Adjusted hazard ratio remained elevated even 25 years after diagnosis, corresponding to one additional stroke per 93 IBD patients

By Elana Gotkine HealthDay Reporter

THURSDAY, June 15, 2023 (HealthDay News) — Patients with inflammatory bowel disease (IBD) have increased risk of stroke, according to a study published online June 14 in Neurology.

Jiangwei Sun, Ph.D., from the Karolinska Institute in Stockholm, and colleagues examined the risk of stroke among patients with a biopsy-confirmed IBD in Sweden between 1969 and 2019 and five matched reference individuals per patient randomly selected from the general population and IBD-free full siblings. Stroke was identified from the Swedish National Patient Register. The analysis included 85,006 patients with IBD; 406,987 matched reference individuals; and 101,082 IBD-free full siblings.

The researchers identified 3,720 incident strokes in IBD patients and 15,599 in reference individuals (incidence rates, 32.6 and 27.7 per 10,000 person-years, respectively; adjusted hazard ratio, 1.13). Even 25 years after diagnosis, the elevated adjusted hazard ratio remained increased, corresponding to one additional stroke case per 93 IBD patients. The excess adjusted hazard ratio was mainly due to ischemic stroke (adjusted hazard ratio, 1.14) and not hemorrhagic stroke. Across IBD subtypes, the risk of ischemic stroke was significantly increased (adjusted hazard ratios, 1.19, 1.09, and 1.22 for Crohn disease, ulcerative colitis, and IBD-unclassified, respectively). When IBD patients were compared to their siblings, the results were similar.

“These results show that people with inflammatory bowel disease and their doctors should be aware of this long-term increased risk,” Sun said in a statement. “Screening and management of stroke risk factors may be more urgent in people with inflammatory bowel disease.”

Several authors disclosed ties to the pharmaceutical industry; the study was funded by Forte.

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