Relationship between venous thromboembolism and inflammatory bowel disease in Taiwan: a nationwide retrospective cohort study

Abstract Background Inflammation significantly influences thrombosis development, with venous thromboembolism (VTE) risk linked to various systemic inflammatory diseases, but not fully established in inflammatory bowel disease (IBD). Using a population-based cohort study conducted in Taiwan, we inve...

Full description

Saved in:
Bibliographic Details
Main Authors: Yi-Jen Fang, Hui-Hsia Hsieh, Heng-Jun Lin, Cheng-Li Lin, Wan-Yi Lee, Chi-Hua Chen, Fuu-Jen Tsai, Bang-Jau You, Ni Tien, Yun-Ping Lim
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Cardiovascular Disorders
Subjects:
Online Access:https://doi.org/10.1186/s12872-025-04600-3
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850252009872031744
author Yi-Jen Fang
Hui-Hsia Hsieh
Heng-Jun Lin
Cheng-Li Lin
Wan-Yi Lee
Chi-Hua Chen
Fuu-Jen Tsai
Bang-Jau You
Ni Tien
Yun-Ping Lim
author_facet Yi-Jen Fang
Hui-Hsia Hsieh
Heng-Jun Lin
Cheng-Li Lin
Wan-Yi Lee
Chi-Hua Chen
Fuu-Jen Tsai
Bang-Jau You
Ni Tien
Yun-Ping Lim
author_sort Yi-Jen Fang
collection DOAJ
description Abstract Background Inflammation significantly influences thrombosis development, with venous thromboembolism (VTE) risk linked to various systemic inflammatory diseases, but not fully established in inflammatory bowel disease (IBD). Using a population-based cohort study conducted in Taiwan, we investigated the impact of IBD on the risk of VTE, deep vein thrombosis (DVT), and pulmonary embolism (PE), as well as the impact of anti-IBD treatments. Methods A study was conducted on a cohort of patients with IBD diagnosed between 2010 and 2019 using the National Health Insurance database. The risks of VTE, DVT, and PE, as well as anti-IBD treatment use, were examined using Cox proportional hazard regression analysis. Results The overall number of person-years recorded for 12,126 patients with IBD (mean age: 49.18 years; 55.31% male) and 12,126 controls (mean age: 49.19 years; 55.31% male) was 64,057 and 72,056, with a follow-up duration for the two cohorts was 5.28 and 5.94 years, respectively. After adjusting for age, gender, and comorbidities, the adjusted hazard ratios (aHRs) of VTE, DVT, and PE in patients with IBD were 5.58 [95% confidence interval (CI) = 3.97–7.87], 5.48 (95% CI = 3.83–7.86), and 4.96 (95% CI = 2.00-12.35) times higher, respectively, than those in the control cohort. Male patients with IBD and those under the age of 50 were more likely to develop VTE (aHR = 8.54, 95% CI = 2.00-12.35; aHR = 15.75, 95% CI = 5.73–43.26, respectively). Compared to the cohort of patients with IBD receiving no treatment, patients receiving anti-IBD treatments did not show a significant change in the risk of developing VTE. Additionally, compared to the IV steroid cohort, patients with IBD who only used oral steroids had a substantially lower incidence of VTE, particularly with average doses of ≤ 80 mg (aHR = 0.24, 95% CI = 0.10–0.59). Conclusion Patients with IBD are at an increased risk of developing VTE, particularly DVT and PE. While our study found that anti-IBD treatments did not significantly alter this risk, proactive management of associated factors and close monitoring remains essential for preventing VTE in this population. Identifying and addressing specific associated factors should be prioritized in clinical practice to mitigate the heightened risk of VTE in IBD patients.
format Article
id doaj-art-b777c3ea15034a25a09d3cdaa261c68c
institution OA Journals
issn 1471-2261
language English
publishDate 2025-03-01
publisher BMC
record_format Article
series BMC Cardiovascular Disorders
spelling doaj-art-b777c3ea15034a25a09d3cdaa261c68c2025-08-20T01:57:45ZengBMCBMC Cardiovascular Disorders1471-22612025-03-0125111110.1186/s12872-025-04600-3Relationship between venous thromboembolism and inflammatory bowel disease in Taiwan: a nationwide retrospective cohort studyYi-Jen Fang0Hui-Hsia Hsieh1Heng-Jun Lin2Cheng-Li Lin3Wan-Yi Lee4Chi-Hua Chen5Fuu-Jen Tsai6Bang-Jau You7Ni Tien8Yun-Ping Lim9Department of Post-Baccalaureate Medicine, College of Medicine, National Chung-Hsing UniversityDepartment of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationManagement Office for Health Data, China Medical University HospitalManagement Office for Health Data, China Medical University HospitalDepartment of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDepartment of Pharmacy, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDepartment of Medical Research, China Medical University HospitalDepartment of Chinese Pharmaceutical Sciences and Chinese Medicine Resources, China Medical UniversityDepartment of Laboratory Medicine, China Medical University HospitalDepartment of Pharmacy, College of Pharmacy, China Medical UniversityAbstract Background Inflammation significantly influences thrombosis development, with venous thromboembolism (VTE) risk linked to various systemic inflammatory diseases, but not fully established in inflammatory bowel disease (IBD). Using a population-based cohort study conducted in Taiwan, we investigated the impact of IBD on the risk of VTE, deep vein thrombosis (DVT), and pulmonary embolism (PE), as well as the impact of anti-IBD treatments. Methods A study was conducted on a cohort of patients with IBD diagnosed between 2010 and 2019 using the National Health Insurance database. The risks of VTE, DVT, and PE, as well as anti-IBD treatment use, were examined using Cox proportional hazard regression analysis. Results The overall number of person-years recorded for 12,126 patients with IBD (mean age: 49.18 years; 55.31% male) and 12,126 controls (mean age: 49.19 years; 55.31% male) was 64,057 and 72,056, with a follow-up duration for the two cohorts was 5.28 and 5.94 years, respectively. After adjusting for age, gender, and comorbidities, the adjusted hazard ratios (aHRs) of VTE, DVT, and PE in patients with IBD were 5.58 [95% confidence interval (CI) = 3.97–7.87], 5.48 (95% CI = 3.83–7.86), and 4.96 (95% CI = 2.00-12.35) times higher, respectively, than those in the control cohort. Male patients with IBD and those under the age of 50 were more likely to develop VTE (aHR = 8.54, 95% CI = 2.00-12.35; aHR = 15.75, 95% CI = 5.73–43.26, respectively). Compared to the cohort of patients with IBD receiving no treatment, patients receiving anti-IBD treatments did not show a significant change in the risk of developing VTE. Additionally, compared to the IV steroid cohort, patients with IBD who only used oral steroids had a substantially lower incidence of VTE, particularly with average doses of ≤ 80 mg (aHR = 0.24, 95% CI = 0.10–0.59). Conclusion Patients with IBD are at an increased risk of developing VTE, particularly DVT and PE. While our study found that anti-IBD treatments did not significantly alter this risk, proactive management of associated factors and close monitoring remains essential for preventing VTE in this population. Identifying and addressing specific associated factors should be prioritized in clinical practice to mitigate the heightened risk of VTE in IBD patients.https://doi.org/10.1186/s12872-025-04600-3Inflammatory bowel diseaseAnti-IBD treatmentsVenous thromboembolismCohort studyNational health insurance database
spellingShingle Yi-Jen Fang
Hui-Hsia Hsieh
Heng-Jun Lin
Cheng-Li Lin
Wan-Yi Lee
Chi-Hua Chen
Fuu-Jen Tsai
Bang-Jau You
Ni Tien
Yun-Ping Lim
Relationship between venous thromboembolism and inflammatory bowel disease in Taiwan: a nationwide retrospective cohort study
BMC Cardiovascular Disorders
Inflammatory bowel disease
Anti-IBD treatments
Venous thromboembolism
Cohort study
National health insurance database
title Relationship between venous thromboembolism and inflammatory bowel disease in Taiwan: a nationwide retrospective cohort study
title_full Relationship between venous thromboembolism and inflammatory bowel disease in Taiwan: a nationwide retrospective cohort study
title_fullStr Relationship between venous thromboembolism and inflammatory bowel disease in Taiwan: a nationwide retrospective cohort study
title_full_unstemmed Relationship between venous thromboembolism and inflammatory bowel disease in Taiwan: a nationwide retrospective cohort study
title_short Relationship between venous thromboembolism and inflammatory bowel disease in Taiwan: a nationwide retrospective cohort study
title_sort relationship between venous thromboembolism and inflammatory bowel disease in taiwan a nationwide retrospective cohort study
topic Inflammatory bowel disease
Anti-IBD treatments
Venous thromboembolism
Cohort study
National health insurance database
url https://doi.org/10.1186/s12872-025-04600-3
work_keys_str_mv AT yijenfang relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT huihsiahsieh relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT hengjunlin relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT chenglilin relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT wanyilee relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT chihuachen relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT fuujentsai relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT bangjauyou relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT nitien relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy
AT yunpinglim relationshipbetweenvenousthromboembolismandinflammatoryboweldiseaseintaiwananationwideretrospectivecohortstudy