Post–myocardial infarction complications in patients with inflammatory bowel disease: a retrospective cohort study using the National Inpatient Sample (2016–2022)

Inflammatory bowel disease (IBD) is associated with systemic inflammation and increased cardiovascular risk, but its impact on in-hospital outcomes after acute myocardial infarction (MI) remains unclear. We conducted a retrospective cohort study using the National Inpatient Sample (2016–2022) to identify hospitalizations for acute MI and compared outcomes between patients with and without IBD. Multivariate logistic regression was used to evaluate the association between IBD and post-MI complications. Associations were summarized as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Among 1,456,940 MI hospitalizations, 7,430 had IBD. After adjustment, IBD was associated with higher odds of mortality (aOR 3.32, 95% CI 3.18–3.47; p < 0.0001), left ventricular rupture (aOR 4.46, 95% CI 3.16–6.28; p < 0.0001), left ventricular aneurysm (aOR 1.93, 95% CI 1.61–2.31; p < 0.0001), acute mitral regurgitation (aOR 9.80, 95% CI 6.81–14.10; p < 0.0001), and stent restenosis (aOR 1.16, 95% CI 1.07–1.26; p = 0.0002). IBD was also associated with longer hospital stay (coefficient 2.13 days, 95% CI 2.03–2.23; p < 0.0001) and higher total hospital charges.Conclusion: IBD was associated with worse in-hospital outcomes and higher resource utilization after MI in this nationwide hospitalization-level analysis. Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, causes long-term inflammation in the body. People with IBD may have a higher risk of heart problems, but it is not fully clear whether having IBD affects how patients do after a heart attack.We studied hospital records from a large U.S. database (the National Inpatient Sample) from 2016 to 2022. We included adults hospitalized for an acute myocardial infarction (heart attack) and compared outcomes between patients with IBD and those without IBD.Among about 1.46 million heart attack hospitalizations, about 7,400 involved patients with IBD. After accounting for differences in age, sex, other medical conditions, and hospital factors, patients with IBD had a higher risk of dying during the hospitalization and a higher risk of certain serious heart-related complications. Patients with IBD also stayed in the hospital longer and had higher hospital charges.These results suggest that people with IBD who are hospitalized for a heart attack may be at higher risk for complications and may need closer monitoring during the hospital stay. Because this database does not include details such as IBD severity, medications, or some measures of heart attack severity, future studies are needed to better understand why these differences occur and how to reduce risk.