Nearly One in Five Celiacs in Hospital Also Had Coronary Artery Disease

Celiac.com 11/14/2022 - Some studies have linked coronary artery disease with celiac disease, but hard evidence is scant. To date, there has been no solid medical literature on common risk factors linking celiac disease and coronary artery disease. Risk factors for coronary artery disease include hypertension, hyperlipidemia, type 2 diabetes, obesity, and tobacco use. However, common risk factors connecting celiac disease and coronary artery disease are poorly documented.

A team of researchers recently set out with three goals. First, to assess potential demographic differences between celiac patients with coronary artery disease and without coronary artery disease. Secondly, to examine the risk factors of coronary artery disease in celiac patients. Lastly, to compare celiac-coronary artery disease patients and matched non-celiac coronary artery disease to see if there are more coronary artery disease risks for people with celiac disease.

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The research team included Maryam B. Haider, Paul Naylor, Avijit Das, Syed M. Haider, and Murray N. Ehrinpreis. They are variously affiliated with the Department of Gastroenterology Gastroenterology at Wayne State University in Detroit, MI; the DMC/Wayne State University - Sinai Grace Hospital in Detroit, MI; the Wayne State University School of Medicine in Detroit, MI; and Binghamton University in Binghamton, NY. 

For their nationwide retrospective case-control study, the team used the National Inpatient Sample (NIS) database to identify patients admitted between 2016 and 2018 with a principal or secondary diagnosis of celiac disease. They then assessed sociodemographic and clinical risk factors for coronary artery disease in celiacs, and compared the celiac-coronary artery disease patients with the matched non-celiac coronary artery disease group.

Of nearly 24,000 hospitalizations with celiac disease from 2016 to 2018, nearly 20%, were found to have coronary artery disease. Established coronary artery disease risk factors for celiac patients included hypertension, hyperlipidemia, type 2 diabetes, and a family history of coronary artery disease. Interestingly, tobacco use is not a coronary artery disease risk factor in celiac patients. Odds of coronary artery disease were 55% less likely for female celiac patients, compared to male patients. 

The odds of coronary artery disease were 20% greater in patients with essential hypertension, double in patients with type 2 diabetes, and five times higher in celiac patients with hyperlipidemia.

Patients with coronary artery disease had higher rates of iron deficiency anemia, which were nearly 10% for celiac-coronary artery disease patients, compared with just under 8.3% for non-coronary artery disease celiac patients, and just over 7.3% for people with non-celiac coronary artery disease.

The team's findings confirm that, as with non-celiac individuals, males and individuals of Caucasian race with celiac disease face a higher risk of coronary artery disease. 

They also confirmed that celiac-coronary artery disease patients have a higher rates of hyperlipidemia than non-celiac coronary artery disease patients, while celiacs with type 1 diabetes have an early diagnosis of coronary artery disease, compared to celiacs with type 2 diabetes. 

Lastly, they found that iron deficiency anemia is an important risk factor for coronary artery disease in those with celiac disease. 

Teasing out the common links and risk factors for celiac disease and coronary artery disease is important work, and this study helps to advance that cause. Clearly further, and larger, study will be helpful in our ongoing journey to understand the puzzle that makes up the links celiac, coronary artery disease, and other diseases.

Read more in Cureus 14(6): e26151