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. 2025 Feb;40(2):421-432.
doi: 10.1111/jgh.16831. Epub 2024 Dec 12.

Identifying Risk Factors of Major Adverse Cardiac Events in Patients With Ulcerative Colitis: A Retrospective Japanese Claims Data Analysis

Tomohisa Takagi  1 , Linghua Xu  2 , Masato Hoshi  3 , Shoko Arai  3
Affiliations

Identifying Risk Factors of Major Adverse Cardiac Events in Patients With Ulcerative Colitis: A Retrospective Japanese Claims Data Analysis

Tomohisa Takagi et al. J Gastroenterol Hepatol. 2025 Feb.

Abstract

Background and aim: We conducted a retrospective study to identify incidence rates and potential risk factors of major adverse cardiac events (MACE) in Japanese patients with ulcerative colitis (UC), as existing data are scarce, inconsistent, and provide limited representation of the real-world situation of MACE in Japan.

Methods: We utilized administrative claims data, collected between January 2013 and December 2022, from Medical Data Vision, Japan. Patients (aged ≥ 20 years) diagnosed with UC within ± 1 month of the prescription date during the study period were included in the incident cohort. Exclusions comprised patients diagnosed with UC in the first 365 days or with myocardial infarction, heart failure, stroke, or other ischemic heart diseases within 30 days pre-index. The cumulative incidence rate of MACE was calculated using the Kaplan-Meier method. Multivariate Cox regression models were used to calculate hazard ratios (HRs) for all relevant potential risk factors.

Results: Of 11 407 patients in the incident cohort, 91 (0.8%) experienced incident MACE. Over 120 months, the cumulative incidence rate of MACE was 2.86% (95% confidence interval [CI]: 1.89-4.32). Significant HRs (95% CI) were found for age category (≥ 65 years) (4.557 [2.786-7.452]), diabetes (1.709 [1.030-2.835]), and atrial fibrillation (AF) (2.759 [1.188-6.405]) (all p < 0.05). Patients with a history of stroke showed numerically increased risk (1.871 [0.508-6.886]) of MACE.

Conclusions: The cumulative incidence rate of MACE was 2.86% over 120 months. Age, comorbidities of diabetes and AF, and history of stroke were the major risk factors for MACE in Japanese UC patients.

Keywords: Japan; cardiovascular diseases; claims‐data; major adverse cardiac events; ulcerative colitis.

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Conflict of interest statement

L.X., M.H., and S.A. are employees and stockholders of Pfizer Japan Inc., Japan. T.T. received a collaboration research fund from PreMedica Inc. and received lecture fees from Pfizer Japan Inc., Janssen Pharmaceutical K. K, Mitsubishi Tanabe Pharma Co., Mochida Pharmaceutical Co. Ltd., Takeda Pharmaceutical Co. Ltd, Abbvie GK, and EA Pharma Co. Ltd, and received research funding from Mitsubishi Tanabe Pharma Co.

Figures

FIGURE 1
FIGURE 1
Patient disposition in incident cohort. HF, heart failure; IHD, ischemic heart disease; MI, myocardial infarction; UC, ulcerative colitis.
FIGURE 2
FIGURE 2
Kaplan–Meier curve of cumulative MACE incidence. CI, confidence interval; MACE, major adverse cardiac event.
See this image and copyright information in PMC

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