A248 RISK OF ARRHYTHMIA IN INFLAMMATORY BOWEL DISEASE
Bibliographic record
Abstract
Abstract Background Inflammatory bowel disease (IBD) has been shown to be associated with stroke or early atherosclerosis. Atrial fibrillation (AF), being the most common arrhythmia seen clinically, can be a consequence of systemic inflammation. The association between IBD and arrhythmia has been studied in recent literature with inconclusive evidence. Aims 1. To determine the risk of arrhythmia (defined as AF, other supraventricular or ventricular tachycardia) in IBD. 2. To compare the risk of arrhythmia amongst IBD medications. 3. To assess mortality in IBD with arrythmia as compared to controls. Methods The risk of arrhythmia was determined in a retrospective population-based cohort study using the University of Manitoba IBD Epidemiology Database (11,432 IBD cases and 109,582 matched controls). Arrhythmia risk in IBD was adjusted for presence of comorbidities of the Charlson Comorbidity Index (CCI). The effect of IBD medications on the development of arrhythmia was assessed in a nested case-control study of individuals with IBD. Follow-up started on date of IBD diagnosis until arrhythmia diagnosis, emigration out of the province of Manitoba, death, or March 31, 2018. Cases were censored at date of first database identification of a diagnosis of heart failure or myocardial infarction. All-cause mortality was a secondary outcome compared across non-IBD controls and IBD cases with arrhythmia using proportional hazards regression analysis was done. Results Persons diagnosed with IBD were more likely than controls (HR 1.51; 95% CI 1.30-1.76) to develop arrhythmia. When controlling for CCI comorbidities, the significant association between IBD and arrhythmia remains. Medications including 5-ASA, thiopurines, and TNFa inhibitors were not associated with arrhythmia, with OR 0.99 (95% CI, 0.68-1.45), 1.06 (95% CI, 0.57-1.97), and 0.90 (95% CI, 0.31-2.61), respectively. All-cause mortality was slightly increased in persons with IBD in analyses unadjusted and adjusted for the presence of arrhythmia, with HR's of 1.13 (1.07-1.19) and 1.12 (1.06-1.18). Increased mortality was more pronounced in CD, but UC did not raise risk of mortality. Conclusions Persons with IBD have a higher risk of arrhythmia even prior to a diagnosis with heart disease. IBD medications did not raise risk of arrhythmia in our dataset. All-cause mortality, with the development arrhythmia as a time dependent variable, was significantly raised in CD as compared to non-IBD controls, but not in UC. Further data are necessary to establish the risk of arrhythmia in IBD, especially with stratification by setting of arrhythmia diagnosis and severity of IBD based on Montreal classification. Funding Agencies None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".