An Investigation into the Association Between Inflammatory Bowel Disease and Cardiac Arrhythmias: An Examination of the United States National Inpatient Sample Database

Abstract

Background: Inflammatory bowel diseases (IBD) associated-chronic inflammation and autonomic dysregulation may predispose to arrhythmias. However, its exact prevalence is unknown. Thus, we aimed to ascertain the prevalence of arrhythmias in patients with IBD. Methods: We queried the Nationwide Inpatient Sample (the largest publicly available all-payer inpatient USA database) from 2012 to 2014. We used the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) discharge codes to identify adult patients (⩾18 years) with IBD and dysrhythmias (supraventricular tachycardia (SVT), atrial fibrillation, atrial flutter, ventricular tachycardia (VT), or ventricular fibrillation). Furthermore, we identified risk factors for cardiovascular disease. We divided patients into 2 cohorts, IBD cohorts, and non-IBD cohort. The independent effect of a diagnosis of IBD on the risk of dysrhythmias was examined using a multivariable logistic regression model controlling for multiple confounders. Results: We identified 847 235 and 84 757 349 weighted hospitalizations among patients with IBD and non-IBD cohorts, respectively. Patients with IBD were less likely to be hospitalized for dysrhythmias than the non-IBD (9.7% vs 14.2%, P < .001). The hospitalization odds for dysrhythmias among patients with IBD were less than the general population (OR 0.87; 95% CI 0.85-0.88). However, the prevalence of SVT and VT was indifferent between the 2 groups. Male sex, age of over 60, and white race were risk factors for dysrhythmias. Conclusion: Despite prior reports of a higher prevalence of arrhythmias among patients with IBD, in a nationwide inpatient database, we found lower rates of hospitalization-related-arrhythmias in the IBD population compared to that of the general population.

Impact of atrial fibrillation on inflammatory bowel disease hospitalizations—a nationwide retrospective study

“…15 Most studies have noted a female and Caucasian predominance in this patient population. 16,17 In our study, the prevalence and mean age for IBD hospitalizations with AF was noted to be 4.2% (3900 patients) and 70.9 years, respectively. These findings were in line with current literature.…”

Does Chronic Intestinal Inflammation Promote Atrial Fibrillation: A Mendelian Randomization Study With Populations of European Ancestry

“…During the follow-up of a population-based cohort study, patients with IBD were identified at a 36% (95% CI, 20–54%) higher risk of AF than controls ( 6 ). On the contrary, using the nationwide inpatient database in the United States, patients with IBD were found less likely to be hospitalized for arrhythmias than the non-IBD (9.7 vs. 14.2%, p < 0.001) ( 7 ). The potential biases of confounding factors and reverse causation may contribute to such controversy ( 8 ), leaving the specific relationship between IBD and AF yet to be determined.…”

The Impact of Inflammatory Bowel Disease on Mortality and Other Outcomes of Hospitalized Patients With Diabetic Ketoacidosis: An Observational Study of the United States National Inpatient Sample

“…Additionally, hospital characteristics were incorporated into the analysis (hospital region, hospital bed size, location, and teaching status). The NIS database has been previously used to successfully identify the impact of IBD on different groups of patients [ 17 ].…”