Microscopic Colitis Raises Risk for Cardiac Events

Microscopic Colitis Raises Risk for Cardiac Events


Patients with microscopic colitis have a 27% higher risk for major adverse cardiovascular events (MACE), equal to one extra case of MACE for every 13 patients followed for 10 years.


  • The cohort included 11,018 Swedish adults (1990–2017) with biopsy-proven microscopic colitis without prior cardiovascular disease (CVD), who were matched to 48,371 reference individuals without microscopic colitis or CVD.

  • Multivariable-adjusted hazard ratios for MACE were calculated using Cox proportional hazards modeling.


  • Over a median of 6.6 years of follow-up, 2181 (20%) incident cases of MACE were confirmed in patients with microscopic colitis; 6661 (14%) were confirmed in the reference population.

  • Patients with microscopic colitis had a higher overall risk for MACE outcomes compared with the reference population (adjusted hazard ratio [aHR], 1.27).

  • Of the individual MACE components, patients with microscopic colitis had a higher risk for ischemic heart disease (aHR, 1.38), congestive heart failure (aHR, 1.32), and stroke (aHR, 1.12), but not cardiovascular mortality (aHR, 1.07).

  • Results remained robust in sensitivity analyses.


The increased risk for MACE in patients with microscopic colitis highlights the need for awareness of CVD risk factors among these patients. “Patients with microscopic colitis could be considered for a personalized cardiovascular disease risk assessment,” the authors write.


Anders Forss, MD, with Karolinska Institutet, Stockholm, Sweden, led the research, which was published online May 25 in Clinical Gastroenterology and Hepatology. The study was funded by Janssen Corporation.


Possible undiagnosed microscopic colitis in the reference population; a lack of data on certain risk factors for microscopic colitis and CVD, such as body mass index, alcohol, diet, and lipid profiles; and potential surveillance bias may have influenced the results.


Several authors reported relationships with Janssen, AbbVie, Takeda, Pfizer, MSD, Anagram kommunikation AB, and Symptoms Europe AB.

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