Risk of vascular diseases in patients with dermatitis herpetiformis and coeliac disease: a long-term cohort study

Figures & data

Table 1. Demographic data and studied comorbidities of dermatitis herpetiformis (DH) and coeliac disease patients and their matched references.

	DH		Coeliac disease
	Patients	References	Patients	References
Total, n	368	1099	1072	3197
Females, n (%)	180 (49)	539 (49)	729 (68)	2174 (68)
Age at time of DH or coeliac disease diagnosis, median (IQR), years	39 (5–84)	39 (5–84)	39 (0–85)	39 (0–85)
Age at time of DH or coeliac disease diagnosis, n (%)
Under 18 years	18 (5)	53 (5)	232 (22)	691 (22)
18–40 years	173 (47)	517 (47)	338 (32)	1005 (32)
Over 40 years	177 (48)	529 (48)	502 (47)	1501 (47)
Year of DH or coeliac disease diagnosis, n (%)
Before 1980	87 (24)	259 (24)	110 (10)	329 (10)
Between 1981 and 1990	187 (51)	559 (51)	441 (41)	1314 (41)
Between 1991 and 2001	94 (26)	281 (26)	521 (49)	1554 (49)
Person-years of follow-up	14 883	43 197	42 289	129 013
Follow-up time, median (IQR), years	46 (43–46)	46 (39–46)	46 (39–46)	46 (39–46)
Age at end of follow-up, median (IQR), years	68 (23–96)	67 (17–101)	62 (9–97)	62 (6–100)
Comorbidities, n (%)
Diabetes mellitus	29 (8)^a	132 (12)	115 (11)^a	248 (8)
Hypertension	69 (19)	239 (22)	186 (17)	508 (16)
Atrial fibrillation	47 (13)	147 (13)	120 (11)^a	285 (9)
Hypercholesterolemia	12 (3)	53 (5)	38 (4)	88 (3)
Sleep apnoea	16 (4)	60 (6)	32 (3)	108 (3)
COPD	3 (1)	8 (1)	7 (1)	16 (1)

IQR: interquartile range; COPD: chronic obstructive pulmonary disease.

^aStatistically significant difference when compared to references.

Figure 1. Kaplan-Meier failure curves estimating the cumulative incidence of the cardiovascular diseases studied in dermatitis herpetiformis (DH) patients (A, diabetes mellitus adjusted hazard ratio 1.16; 95% CI 0.91–1.47) and coeliac disease (CeD) patients (B, diabetes mellitus adjusted hazard ratio 1.36; 95% CI 1.17–1.59).

Table 2. Incidence rates and unadjusted and adjusted hazard ratios (HR) with 95% confidence intervals (CI) for different vascular diseases in dermatitis herpetiformis (DH) and coeliac disease patients and their matched references during the total follow-up time.

	Patients		References
	Events	Incidence/10,000 PY	Events	Incidence/10,000 PY		HR	95% CI	Adjusted HR^a	95% CI
All cardiovascular diseases studied
DH	93	62.49	246	56.95	1.07	0.84–1.36	1.16	0.91–1.47
Coeliac disease	229	54.15	497	38.52	1.43	1.22–1.67	1.36	1.17–1.59
Coronary artery disease
DH	73	48.79	190	43.62	1.09	0.83–1.43	1.17	0.90–1.54
Coeliac disease	189	44.34	408	31.48	1.43	1.20–1.70	1.36	1.14–1.62
Atherosclerotic valve disease
DH	10	6.41	12	2.66	2.34	1.01–5.43	2.54	1.10–5.92
Coeliac disease	21	4.73	22	1.65	2.90	1.60–5.28	2.86	1.57–5.19
Heart failure
DH	41	26.42	119	26.70	0.97	0.68–1.38	1.06	0.74–1.51
Coeliac disease	91	20.70	211	15.95	1.30	1.02–1.68	1.24	0.97–1.58
All cerebrovascular diseases studied
DH	33	21.39	140	31.63	0.66	0.45–0.96	0.68	0.47–0.99
Coeliac disease	115	26.39	255	19.39	1.38	1.11–1.72	1.33	1.07–1.66
Transient ischemic attack (TIA)
DH	13	8.36	42	9.36	0.87	0.47–1.62	0.89	0.48–1.66
Coeliac disease	55	12.48	96	7.24	1.74	1.25–2.42	1.71	1.23–2.39
Ischemic or thromboembolic stroke
DH	25	16.10	113	25.40	0.61	0.40–0.95	0.65	0.42–0.99
Coeliac disease	75	17.06	181	13.68	1.26	0.96–1.65	1.20	0.92–1.57
All vascular diseases of aorta and peripheral arteries studied
DH	15	9.62	51	11.35	0.83	0.46–1.47	0.88	0.49–1.56
Coeliac disease	43	9.73	11	8.36	1.17	0.82–1.66	1.09	0.77–1.55
Atherosclerosis of aorta and peripheral arteries
DH	11	7.05	37	8.22	0.84	0.43–1.64	0.90	0.46–1.76
Coeliac disease	35	7.91	79	5.94	1.34	0.90–1.99	1.22	0.82–1.82
Aneurysm/ Dissecation of aorta and peripheral arteries
DH	3	1.92	13	2.88	0.65	0.19–2.27	0.67	0.19–2.35
Coeliac disease	9	2.02	33	2.48	0.82	0.39–1.71	0.81	0.22–1.23
Occlusion/embolism of aorta and peripheral arteries
DH	1	0.64	7	1.55	0.40	0.05–3.25	0.43	0.05–3.48
Coeliac disease	9	2.02	20	1.50	1.35	0.62–2.97	1.24	0.56–2.73
All vein thromboses studied
DH	20	12.86	57	12.76	0.98	0.59–1.64	1.04	0.62–1.73
Coeliac disease	74	16.89	135	10.29	1.68	1.26–2.22	1.62	1.22–2.16
Pulmonary embolism
DH	4	2.56	20	4.43	0.56	0.19–1.64	0.62	0.21–1.81
Coeliac disease	21	4.73	46	3.61	1.38	0.82–2.30	1.28	0.77–2.15
Deep vein thrombosis
DH	14	8.99	33	7.36	1.20	0.64–2.24	1.24	0.66–2.33
Coeliac disease	49	11.15	91	6.87	1.64	1.16–2.32	1.61	1.14–2.28
Other vein thrombosis
DH	3	1.92	11	2.44	0.76	0.21–2.73	0.80	0.22–2.86
Coeliac disease	17	3.83	15	1.12	3.43	1.72–6.88	3.38	1.69–6.76

^aAdjusted for diabetes mellitus.

PY: Person years.

Figure 2. Kaplan-Meier failure curves estimating the cumulative incidence of all cerebrovascular outcomes studied in dermatitis herpetiformis (DH) patients (A, diabetes mellitus adjusted hazard ratio 0.68; 95% CI 0.47–0.99) and coeliac disease (CeD) patients (B, diabetes mellitus adjusted hazard ratio 1.33; 95% CI 1.07–1.66).

Data availability statement

Due to the nature of this research, participants of this study did not agree to their data being shared publicly, so supporting data is not available.