Patients With IBD at Higher Risk of Stroke

Regardless of the duration of inflammatory bowel disease (IBD) or IBD subtype, patients with IBD are at an increased risk of suffering ischemic stroke than general population, according to the results of a large Swedish national cohort study.

“Patients with IBD are at an increased risk of thromboembolic events, but evidence on the long-term risk of stroke remains scarce,” the researchers explained.

To establish the association between IBD and the risk of stroke, the investigators identified 85,006 patients with IBD including Crohn disease (CD, n=25,257), ulcerative colitis (UC, n=47,354), and IBD-unclassified (IBD-U, n=12,395). These patients were each matched with up to 5 people with the same age, gender, and country of residence who did not have IBD, amounting to a total of 406,987 participants.

The findings revealed that patients with IBD-U had a 22% increased risk of stroke (95% CI 1.08-1.37), patients with CD had a 19% increased risk (95% CI 1.10-1.29), and patients with UC had a 9% increased risk (95% CI 1.04-1.16)

The risk was mainly driven by “ischemic stroke (HR 1.14, 95% CI 1.09-1.18) rather than hemorrhagic stroke (HR 1.06, 95% CI 0.97-1.15), and was significantly higher across IBD subtypes,” the authors wrote.

This risk of stroke among patients with IBD remained high even after 25 years of diagnosis.

“These findings highlight the need for clinical vigilance about the long-term excess risk of cerebrovascular events in patients with IBD,” the study concluded.

Reference:
Sun J, Halfvarson J, Appelros P et al. Long-term risk of stroke in patients with inflammatory bowel disease: A population-based, sibling-controlled cohort study, 1969-2019. Neurology. 2023; 101(6):e653-e664. doi: 10.1212/WNL.0000000000207480