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Cardiovascular disease in patients with coeliac disease : A systematic review and meta-analysis
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- Emilsson, Louise (author)
- Primary Care Res Unit Vårdcentralen Värmlands Nysäter, Värmland County, Karlstad, Sweden; Inst Hlth & Soc, Dept Hlth Management & Hlth Econ, Univ Oslo, Oslo, Norway
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- Lebwohl, Benjamin (author)
- Columbia Univ Coll Phys & Surg, Dept Med, Celiac Dis Ctr, New York, NY 10032 USA.;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden.
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- Sundström, Johan (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Uppsala Clin Res Ctr, Dept Med Sci, Uppsala Univ, Uppsala, Sweden
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- Primary Care Res Unit Vårdcentralen Värmlands Nysäter, Värmland County, Karlstad, Sweden; Inst Hlth & Soc, Dept Hlth Management & Hlth Econ, Univ Oslo, Oslo, Norway Columbia Univ Coll Phys & Surg, Dept Med, Celiac Dis Ctr, New York, NY 10032 USA;Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden. (creator_code:org_t)
- Elsevier BV, 2015
- 2015
- English.
- In: Digestive and Liver Disease. - : Elsevier BV. - 1590-8658 .- 1878-3562. ; 47:10, s. 847-852
- Journal article (peer-reviewed)
Abstract
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- Background: Coeliac disease has been associated with an increased risk of cardiovascular disease in some studies, whereas other studies have shown no association. We performed a systematic review and meta-analysis of cardiovascular disease in celiac disease. Methods: Pubmed, Cinahl, EMBASE and Medline via Ovid were searched for relevant articles published until January 5, 2015. English-language articles on studies with more than 20 patients were included, and were quality rated using the GRADE risk of bias tool. We used random-effects models and assessed heterogeneity using the I-2 statistic. Results: Ten studies were relevant, reporting the risk of myocardial infarction, cardiovascular death and stroke in 33,128/32,903/32,466 coeliac disease patients respectively. Only one study examined celiac disease and a composite measure of cardiovascular disease and this study found a hazard ratio of 1.10 (95% CI 1.03-1.28). In a meta-analysis, we observed an increased risk of stroke (OR 1.11; 95% CI 1.02-1.20). The risks of myocardial infarction (OR 1.12; 95% CI 0.83-1.40) and cardiovascular death (OR 1.12; 95% CI 0.96-1.29) were similar but were estimated with less certainty. Heterogeneity was low for all outcomes except for myocardial infarction where it was moderate. Conclusion: Coeliac disease was associated with a modestly increased risk of cardiovascular disease, but the evidence base is limited.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Celiac
- Coeliac
- Cardiovascular disease
- Meta-analysis
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- ref (subject category)
- art (subject category)
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