Format

Send to

Choose Destination
PLoS One. 2015 Jan 30;10(1):e0117529. doi: 10.1371/journal.pone.0117529. eCollection 2015.

Mucosal healing and the risk of ischemic heart disease or atrial fibrillation in patients with celiac disease; a population-based study.

Author information

1
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, United States of America; Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital and Karolinska Institute, Stockholm, Swede0060045.
2
Primary care research unit, Vårdcentralen Värmlands Nysäter, Värmland County, and the Department of Medicine, Örebro University, Örebro, Sweden.
3
Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
4
Division of Cardiology, Department of Medicine, and Department of Radiology, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, New York, United States of America.
5
Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, United States of America.
6
Department of Medical Epidemiology and Biostatistics, Karolinska University Hospital and Karolinska Institute, Stockholm, Swede0060045; Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.

Abstract

BACKGROUND:

Patients with celiac disease (CD), characterized histologically by villous atrophy (VA) of the small intestine, have an increased risk of ischemic heart disease (IHD) and atrial fibrillation (AF), risks that persist for years after commencing the gluten-free diet. It is unknown whether persistent VA on follow-up biopsy, rather than mucosal healing, affects the risk of IHD or AF.

METHODS:

We identified patients with histologic evidence of CD diagnosed at all 28 pathology departments in Sweden. Among patients who underwent a follow-up small intestinal biopsy, we compared patients with persistent VA to those who showed histologic improvement, with regard to the development of IHD (angina pectoris or myocardial infarction) or AF.

RESULTS:

Among patients with CD and a follow-up biopsy (n = 7,440), the median age at follow-up biopsy was 25 years, with 1,063 (14%) patients who were ≥ 60 years at the time of follow-up biopsy. Some 196 patients developed IHD and 205 patients developed AF. After adjusting for age, gender, duration of CD, calendar period, and educational attainment, there was no significant effect of persistent VA on IHD (adjusted HR 0.97; 95%CI 0.73-1.30). Adjusting for diabetes had a negligible effect (adjusted HR 0.98; 95%CI 0.73-1.31). There was no significant association between persistent VA and the risk of AF (adjusted HR 0.98; 95%CI 0.74-1.30).

CONCLUSIONS:

In this population-based study of patients with CD, persistent VA on follow-up biopsy was not associated with an increased risk of IHD or AF. Failed mucosal healing does not influence the risk of these cardiac events.

PMID:
25635403
PMCID:
PMC4312018
DOI:
10.1371/journal.pone.0117529
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Public Library of Science Icon for PubMed Central
Loading ...
Support Center