P3298 - Long-Term Heart Failure Risk Reduction in Inflammatory Bowel Disease: Biologic vs Non-Biologic Therapy

Omar Arman, MD, MPH¹, Khaled Rafeh, MD², Laith M.. Haj-Ahmad, MD³, Kamal Hamad, MD⁴, Mazen Zamzam, BS⁵, Jad Bou-Abdallah, MD¹
1University at Buffalo, Buffalo, NY; 2School of Medicine, The University of Jordan, Shmeisani, 'Amman, Jordan; 3University of Jordan, Amman, 'Amman, Jordan; 4Jordan University of Science and Technology, Irbid, Irbid, Jordan; 5Oakland University William Beaumont School of Medicine, Royal Oak, MI

Introduction: Inflammatory bowel disease (IBD) is associated with systemic inflammation, increasing heart failure risk, particularly during flares. Biologic therapy may reduce this risk by controlling inflammation, yet limited research compares its impact to non-biologic therapies. This study evaluates whether biologic therapy reduces heart failure risk in IBD patients compared to non-biologic therapy over 1, 3, and 5 years.

Methods: We obtained data from the TriNetX Research Network, including electronic medical records of 225,303 IBD patients from 94 healthcare organizations. We included adult patients (≥18 years) with Crohn’s disease or ulcerative colitis and excluded those with prior heart failure, arrhythmia, myocardial infarction, or stroke. Patients were divided into biologic and non-biologic therapy cohorts, and propensity score matching was performed to balance demographics, comorbidities, and disease severity. Final cohort sizes were 16,179 (1 year), 16,181 (3 years), and 15,821 (5 years). We used Kaplan-Meier survival analysis to evaluate heart failure-free survival probabilities and calculated hazard ratios (HRs) to compare risks.

Results: At 5 years, biologic therapy significantly reduced heart failure risk compared to non-biologic therapy, with a risk difference of 0.22% (p < 0.0001). Risk differences were also significant at 3 years (0.25%, p < 0.0001) and 1 year (0.07%, p = 0.040). Kaplan-Meier survival analysis demonstrated higher heart failure-free survival probabilities in biologic-treated patients at all time points, with HRs (95% CI) of 2.09 (1.02-4.29) at 1 year, 3.39 (1.94-5.90) at 3 years, and 2.53 (1.53-4.17) at 5 years. Detailed statistics are provided in Table 1, with visual summaries in Figure 1.

Discussion: Biologic therapy significantly reduces heart failure risk in IBD patients, with substantial benefits observed over 1, 3, and 5 years. These findings highlight the potential of biologic therapy to reduce cardiovascular complications in IBD, likely through inflammation control. Despite propensity score matching, the retrospective design limits causality. Prospective studies are needed to confirm these findings and explore mechanisms underlying the cardioprotective effects of biologics in IBD patients.


Figure: Figure 1. Comparison of Risk Differences and Hazard Ratios for Heart Failure in Biologic vs. Non-Biologic Therapy at 1, 3, and 5 Years.


Figure: Table 1. Key statistics for heart failure outcomes in patients taking biologic vs non-biologic therapy.

Disclosures:
Omar Arman indicated no relevant financial relationships.
Khaled Rafeh indicated no relevant financial relationships.
Laith Haj-Ahmad indicated no relevant financial relationships.
Kamal Hamad indicated no relevant financial relationships.
Mazen Zamzam indicated no relevant financial relationships.
Jad Bou-Abdallah indicated no relevant financial relationships.

Omar Arman, MD, MPH¹, Khaled Rafeh, MD², Laith M.. Haj-Ahmad, MD³, Kamal Hamad, MD⁴, Mazen Zamzam, BS⁵, Jad Bou-Abdallah, MD¹. P3298 - Long-Term Heart Failure Risk Reduction in Inflammatory Bowel Disease: Biologic vs Non-Biologic Therapy, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.