Inflammatory bowel disease (IBD) is a complex chronic disorder characterized by systemic inflammation, which may cause abnormal state of coagulation, resulting in cardiac events. This study aimed to investigate the incidences and risks of cardiac events in patients with IBD in China.A retrospective cohort study was performed comprising 1,435 patients with IBD from 12 IBD centers in China. Cases were matched with 1,588 eligible participants without IBD from 12 medical centers according to age, sex, and laboratory parameters.Patients with IBD in China exhibited significantly higher incidences of ischemic heart disease (IHD) (coronary heart disease included) but lower frequencies of right bundle branch block and premature contraction than those of matched controls. The risk of IHD increased in patients with IBD, peaking at the age of 18-35 years. Female patients with IBD were more likely to experience IHD than male patients. C-reactive protein (CRP) levels and neutrophil count in the peripheral blood were positively related with the risk of IHD among patients with Crohn's disease (CD), whereas plasma fibrinogen levels were negatively related with the risk of IHD both in patients with CD and UC.The risk of IHD is increased in patients with IBD, especially in young female patients with IBD when compared to matched non-IBD subjects. CRP and plasma fibrinogen levels and neutrophil count in the peripheral blood may be potential predictors associated with the occurrence of IHD in patients with IBD. The study's findings have significant implications for the management and prevention of cardiac events in patients with IBD.© 2021 Crohn’s & Colitis Foundation. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.