Lisa L Strate1, Rune Erichsen2, Erzsébet Horváth-Puhó2, Lars Pedersen2, John A Baron3, Henrik Toft Sørensen2. 1. Department of Medicine, University of Washington School of Medicine, Seattle, Washington. Electronic address: lstrate@uw.edu. 2. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark. 3. Department of Medicine, University of North Carolina, Chapel Hill, North Carolina.
Abstract
BACKGROUND & AIMS: Diverticular disease and cardiovascular disease share several risk factors. Inflammation associated with diverticular disease could predispose to cardiovascular disease. We assessed the association between a diagnosis of diverticular disease and subsequent arterial and venous thromboembolic events, adjusting for related comorbidities to explore a possible causal relationship. METHODS: We identified 77,065 incident cases of diverticular disease from 1980-2011 from Danish nationwide medical registries; these were matched for age and sex with 302,572 population comparison cohort members. Individuals with a history of cardiovascular disease were excluded. We used Cox proportional hazards regression to compute incidence rate ratios, comparing the incidence of acute myocardial infarction, stroke, venous thromboembolism, and subarachnoid hemorrhage in patients with diverticular disease with those of the population cohort members, adjusting for age, sex, obesity, diabetes, hyperlipidemia, chronic obstructive pulmonary disease, connective tissue disease, renal disease, and treatments and medications. RESULTS: The adjusted incidence rate ratios for patients with diverticular disease, compared with population cohort members, were 1.11 (95% confidence interval [CI], 1.07-1.14) for acute myocardial infarction, 1.11 (95% CI, 1.08-1.15) for overall stroke, 1.36 (95% CI, 1.30-1.43) for overall venous thromboembolism, and 1.27 (95% CI, 1.09-1.48) for subarachnoid hemorrhage. The relative risk of each event remained increased after we adjusted for changes in aspirin use or for endoscopy or colorectal surgery after the diagnosis of diverticular disease. These findings also held after excluding the first year of follow-up and limiting the analysis to patients with diverticulitis. CONCLUSIONS: On the basis of an analysis of Danish medical registries, a diagnosis of diverticular disease is associated with a modest increase in risk of arterial and venous thromboembolic events after adjustment for related disorders.
BACKGROUND & AIMS:Diverticular disease and cardiovascular disease share several risk factors. Inflammation associated with diverticular disease could predispose to cardiovascular disease. We assessed the association between a diagnosis of diverticular disease and subsequent arterial and venous thromboembolic events, adjusting for related comorbidities to explore a possible causal relationship. METHODS: We identified 77,065 incident cases of diverticular disease from 1980-2011 from Danish nationwide medical registries; these were matched for age and sex with 302,572 population comparison cohort members. Individuals with a history of cardiovascular disease were excluded. We used Cox proportional hazards regression to compute incidence rate ratios, comparing the incidence of acute myocardial infarction, stroke, venous thromboembolism, and subarachnoid hemorrhage in patients with diverticular disease with those of the population cohort members, adjusting for age, sex, obesity, diabetes, hyperlipidemia, chronic obstructive pulmonary disease, connective tissue disease, renal disease, and treatments and medications. RESULTS: The adjusted incidence rate ratios for patients with diverticular disease, compared with population cohort members, were 1.11 (95% confidence interval [CI], 1.07-1.14) for acute myocardial infarction, 1.11 (95% CI, 1.08-1.15) for overall stroke, 1.36 (95% CI, 1.30-1.43) for overall venous thromboembolism, and 1.27 (95% CI, 1.09-1.48) for subarachnoid hemorrhage. The relative risk of each event remained increased after we adjusted for changes in aspirin use or for endoscopy or colorectal surgery after the diagnosis of diverticular disease. These findings also held after excluding the first year of follow-up and limiting the analysis to patients with diverticulitis. CONCLUSIONS: On the basis of an analysis of Danish medical registries, a diagnosis of diverticular disease is associated with a modest increase in risk of arterial and venous thromboembolic events after adjustment for related disorders.
Authors: Wenjie Ma; Manol Jovani; Long H Nguyen; Fred K Tabung; Mingyang Song; Po-Hong Liu; Yin Cao; Idy Tam; Kana Wu; Edward L Giovannucci; Lisa L Strate; Andrew T Chan Journal: Clin Gastroenterol Hepatol Date: 2019-11-08 Impact factor: 11.382
Authors: Idy Tam; Po-Hong Liu; Lisa L Strate; Edward L Giovannucci; Wenjie Ma; Yin Cao; Manol Jovani; Kana Wu; Eric B Rimm; Andrew T Chan Journal: Dig Dis Sci Date: 2021-03-26 Impact factor: 3.487
Authors: Matthias C Reichert; Juozas Kupcinskas; Antje Schulz; Christoph Schramm; Susanne N Weber; Marcin Krawczyk; Christoph Jüngst; Markus Casper; Frank Grünhage; Beate Appenrodt; Vincent Zimmer; Algimantas Tamelis; Jaune I Lukosiene; Neringa Pauziene; Gediminas Kiudelis; Laimas Jonaitis; Tobias Goeser; Maciej Malinowski; Matthias Glanemann; Limas Kupcinskas; Frank Lammert Journal: Sci Rep Date: 2020-02-03 Impact factor: 4.379