With great interest, we read the article by Leibovitzh et al,1 in which the authors identified 25 proteins as novel biomarkers for Crohn’s disease (CD) in first-degree relatives (FDRs) of patients with CD. These findings enhance our understanding of the inflammatory bowel disease (IBD) pathogenesis and underscore the role of gene variants in signalling aberrations.2 Interestingly, some serum proteins associated with CD onset (eg, CXCL9 and MMP9) have also been implicated in the development of cardiovascular disease (CVD).3 Although an increased risk of CVD has been documented in patients with IBD,4 including a recent paper in Gut,5 whether their family members (including FDRs and spouses) are also more susceptible to CVD due to shared genetic or environmental factors remains unclear.

We conducted a nationwide multigenerational cohort study to investigate CVD risk in family members of patients with IBD (online supplemental methods). From the nationwide histopathology cohort, Epidemiology Strengthened by histoPathology Reports in Sweden,6 we identified individuals with biopsy-confirmed IBD (1969–2017) who had >1 family member living in Sweden at the diagnosis date. For each patient, up to five IBD-free reference individuals were matched from the general population. Then, we identified family members of the index individuals (ie, patients with IBD and their reference individuals) and followed them from the latter of the following dates (ie, index date): the date they turned 18 or the date the index …