Overview of Link Between Inflammatory Bowel Disease and Cardiovascular Disease

In recent years, there has been a steady increase in the incidence of inflammatory bowel disease (IBD) worldwide. Treatment of ulcerative colitis and Crohn’s disease has become more effective thanks to the emergence of biological therapies, increased access to specialized care and a “treat to target” approach. However, with an increase in the life expectancy of patients with IBD, there is an increase in the number of persons with comorbidity, primarily with a combination of IBD with cardiovascular pathology. Environmental factors lead to a change in the diversity and density of colonization of the intestinal microbiota, a violation of its barrier function, immune dysregulation, which in turn leads to the development of chronic inflammatory diseases and atherosclerosis. Levels of proinflammatory cytokines, C-reactive protein, and homocysteine increase in IBD, leading to endothelial dysfunction and atherosclerosis. In addition, inflammatory processes in IBD promote hypercoagulation, which occurs both in the thromboembolic complications and in the pathogenesis of the disease itself. It has been suggested that medical pathogenetic therapy for IBD is also associated with the risk of cardiovascular disease. In this review, we systematize the available data on the risks of cardiovascular diseases in patients with IBD. A literature search containing information on relevant studies was carried out in PubMed and Google Scholar systems with the keywords: inflammatory bowel disease, cardiovascular disease, inflammation, atherosclerosis.

Download Full-text

The role of coexisting cardiovascular disease on disease severity in patients with inflammatory bowel disease

European Journal of Gastroenterology & Hepatology ◽

10.1097/meg.0000000000001767 ◽

2020 ◽

Vol 32 (11) ◽

pp. 1480-1481

Author(s):

Linling Lyu ◽

Dongfeng Chen ◽

Minhao Yu ◽

Yang Yang

Keyword(s):

Cardiovascular Disease ◽

Inflammatory Bowel Disease ◽

Disease Severity ◽

Bowel Disease ◽

Inflammatory Bowel

Download Full-text

Cardiovascular Risk Assessment and Impact of Medications on Cardiovascular Disease in Inflammatory Bowel Disease

Inflammatory Bowel Diseases ◽

10.1093/ibd/izaa258 ◽

2020 ◽

Author(s):

Preetika Sinh ◽

Raymond Cross

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Inflammatory Bowel Disease ◽

Cardiovascular Risk ◽

Lupus Erythematosus ◽

Bowel Disease ◽

Severe Heart Failure ◽

Janus Kinase ◽

Increased Risk ◽

Inflammatory Bowel

Abstract There is increased risk of cardiovascular disease in patients with chronic inflammatory disorders such as rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus. Studies have shown association between cardiovascular disease (eg, myocardial infarction, heart failure, stroke) and inflammatory bowel disease. Medications such as infliximab and adalimumab (monoclonal antibodies to tumor necrosis factor α) may help decrease the inflammatory burden and cardiovascular risk; however, there have been reports of hypertriglyceridemia and worsening of moderate to severe heart failure with these medications. Janus kinase inhibitors, such as tofacitinib, have been associated with hyperlipidemia and thromboembolism. We aim to discuss clinical and imaging modalities to assess cardiovascular risk in inflammatory bowel disease patients and review the role of various medications with respect to cardiovascular disease in this population.

Download Full-text

The Effect of Immunosuppressive Therapy on Cardiovascular Disease in Patients With Inflammatory Bowel Disease

The American Journal of Gastroenterology ◽

10.14309/00000434-201410002-01624 ◽

2014 ◽

Vol 109 ◽

pp. S481

Author(s):

Sudeep Thapa ◽

Hiba Hadid ◽

Syed-Mohammed Jafri ◽

Mohammed Imam ◽

Jason Schairer

Keyword(s):

Cardiovascular Disease ◽

Inflammatory Bowel Disease ◽

Immunosuppressive Therapy ◽

Bowel Disease ◽

Inflammatory Bowel

Download Full-text

Inflammatory bowel disease and cardiovascular disease incidence and mortality: A meta-analysis

European Journal of Preventive Cardiology ◽

10.1177/2047487318792952 ◽

2018 ◽

Vol 25 (15) ◽

pp. 1623-1631 ◽

Cited By ~ 10

Author(s):

Hong-Hao Sun ◽

Feng Tian

Keyword(s):

Cardiovascular Disease ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Disease Incidence ◽

Meta Analysis ◽

Random Effect Model ◽

Effect Model ◽

Incidence And Mortality ◽

Inflammatory Bowel ◽

Cardiovascular Disease Incidence

Background The risk of cardiovascular disease occurrence and death in inflammatory bowel disease patients is still unclear. Design Meta-analysis. Methods Pertinent studies were identified by searching articles in PubMed and Web of Knowledge to December 2017 and reviewing the reference lists of the retrieved articles. We used the fixed-effect model to pool the study-specific estimates when there was no indication of heterogeneity; otherwise, the random-effect model was used. Results A total of 27 articles was included, of which 11 studies reported the risk of cardiovascular disease incidence and 16 studies reported the risk of cardiovascular disease death. The pooled relative risks were 1.25 (95% confidence interval (CI): 1.08, 1.44), 1.17 (95% CI: 1.07, 1.27) and 1.12 (95% CI: 1.05, 1.21) for cerebrovascular disease, coronary heart disease and myocardial infarction, respectively. In particular, the pooled relative risk was much higher in females. The pooled standardized mortality ratios were 1.01 (95% CI: 0.90, 1.14) for Crohn's disease patients and 0.93 (95% CI: 0.86, 1.01) for ulcerative colitis patients with low heterogeneity across studies. No publication bias was detected. Conclusions There was a positive association between inflammatory bowel disease and higher risk of cardiovascular disease incidence, particularly in females. Such an association was not observed for cardiovascular disease mortality.

Download Full-text