Abstract

Objectives To evaluate the risk of cardiovascular disease in individuals with coeliac disease (CD).

Design We used Swedish national hospital-based register data to identify 13,358 individuals who had received a diagnosis of CD (1964-2003) and 64,118 age- and sex-matched individuals without CD. We then used Cox regression to estimate the risk of vascular disease in subjects with CD. Analyses were restricted to individuals with a follow-up of >1 year and with no vascular disease prior to study entry.

Results CD was associated with (Hazard ratios (HR); 95% CI HR): myocardial infarction (1.27; 1.09-1.48), angina pectoris (1.46; 1.25-1.70), heart failure (1.41; 1.22-1.62), brain haemorrhage (1.40; 1.05-1.88), and ischaemic stroke (1.35; 1.14-1.60). These risk estimates were similar when we restricted our analyses to adults in whom vascular disease had been listed as the main diagnosis. In post-hoc analyses, where reference individuals were restricted to inpatients, we found no association with CD of later vascular disease, except for a lower risk of heart failure (0.79; 0.68-0.92).

Conclusions The positive association between CD and later vascular disease may be explained by ascertainment bias.