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Cardiovascular disease in patients with coeliac disease: A systematic review and meta-analysis
Primary Care Res Unit Vårdcentralen Värmlands Nysäter, Värmland County, Karlstad, Sweden; Inst Hlth & Soc, Dept Hlth Management & Hlth Econ, Univ Oslo, Oslo, Norway.ORCID iD: 0000-0001-9137-2800
Dept Med, Celiac Dis Ctr, Columbia Univ Coll Phys & Surg, New York NY, USA; Dept Med Epidemiol & Biostat, Karolinska Inst, Stockholm, Sweden.
Uppsala Clin Res Ctr, Dept Med Sci, Uppsala Univ, Uppsala, Sweden.ORCID iD: 0000-0003-2247-8454
Örebro University Hospital. Dept Med Epidemiol & Biostat, Karolinska Inst, Stockholm, Sweden; Dept Pediat, Örebro University Hospital, Örebro, Sweden.
2015 (English)In: Digestive and Liver Disease, ISSN 1590-8658, E-ISSN 1878-3562, Vol. 47, no 10, p. 847-852Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier, 2015. Vol. 47, no 10, p. 847-852
Keywords [en]
Celiac, Coeliac, Cardiovascular disease, Meta-analysis
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:oru:diva-56345DOI: 10.1016/j.dld.2015.06.004ISI: 000361846700007PubMedID: 26160499OAI: oai:DiVA.org:oru-56345DiVA, id: diva2:1081796
Available from: 2017-03-15 Created: 2017-03-15 Last updated: 2018-07-06Bibliographically approved

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Emilsson, LouiseSundstrom, JohanLudvigsson, Jonas F.
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