Cardiovascular risk factors are not present in adolescents with inflammatory bowel disease

2020 ◽  
Vol 109 (11) ◽  
pp. 2380-2387 ◽  
Author(s):  
Lev Dorfman ◽  
Itai Ghersin ◽  
Neron Khateeb ◽  
Saleh Daher ◽  
Raanan Shamir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Bowel Disease ◽  
Inflammatory Bowel

P6391Major acute cardiovascular events in patients with inflammatory bowel disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
G Gill ◽  
S Fernandez ◽  
M Soud ◽  
M Mete ◽  
N Malhotra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Inflammatory Bowel Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Bowel Disease ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Inflammatory Bowel

Abstract Introduction Traditional risk factors for coronary heart disease have been reported in around 85% patients who present with myocardial infarction. More recently, inflammation and immune mediated diseases have been associated with ischemic heart disease. Inflammatory Bowel Disease (IBD) is an immune mediated disorder which comprises of ulcerative colitis and Crohn's disease. Estimated prevalence of IBD in the United States in 2004 was 1.4 million people. These patients have an overall increased risk of thrombotic complications with microvascular thrombosis hypothesized to contribute in disease pathogenesis. Results from a recent meta-analysis were consistent with increased risk of ischemic heart disease among IBD patients, with risk greater in females and younger patients, although heterogeneity was considerable in overall data. Also, in a recent study, IBD was found to be associated with an increased risk of acute myocardial infarction and heart failure despite lower prevalence of coronary risk factors in IBD patients. IBD pathogenesis involves sustained activation of immune responses with upregulation of cytokines including but not limited to IL-1 beta, IL-6 and TNF-alpha. Upregulation of these cytokines has also been reported in coronary atherosclerosis. Based on above information, we explored incidence of MACE (Major Adverse Cardiac Event) in this patient population from our health system data-base. Methods Propensity scores were estimated for all 15,292 (0.4%) patients with inflammatory bowel disease from a total patient pool of 3,917,894 patients in our health system to assemble a 1:1 matched cohort balanced for age, gender, race and known cardiovascular risk factors including hypertension, hyperlipidemia, diabetes mellitus and smoking (current and former). ICD-9 and ICD-10 codes were used to identify cardiovascular risk factors and outcomes. Results Matched patients (n=30,584) had a mean age of 51 years, with 58% of all being women, and 63% Caucasian. During the median follow up of 4.4 years all-cause mortality was observed in 1.7% and 1.2% of patients from IBD and non-IBD groups respectively (hazard ratio {HR}, 1.31; 95% confidence interval {CI}, 1.08–1.58; p=0.005). Combined outcome for myocardial infarction or all-cause mortality was noted in 4.1% and 3.4% from IBD and non-IBD groups respectively (HR, 1.16; 95% CI, 1.03–1.30; p=0.014) while HRs for cardiovascular mortality, myocardial infarction and unstable angina independently were 1.04 (0.74–1.47; p=0.833), 1.05 (0.89–1.23; p=0.591) and 1.10 (0.83–1.46; p=0.524) respectively. Conclusion Inflammatory bowel disease did not show association with myocardial infarction, cardiovascular mortality or unstable angina when matched for known cardiovascular risk factors, but was associated with increased all-cause mortality and combined end-point of all-cause mortality or myocardial infarction.

scholarly journals EXCESSIVE WEIGHT – MUSCLE DEPLETION PARADOX AND CARDIOVASCULAR RISK FACTORS IN OUTPATIENTS WITH INFLAMMATORY BOWEL DISEASE

2015 ◽  
Vol 52 (1) ◽  
pp. 37-45 ◽  
Author(s):  
Maria Izabel Siqueira de ANDRADE ◽  
Regiane MAIO ◽  
Keila Fernandes DOURADO ◽  
Patrícia Fortes Cavalcanti de MACÊDO ◽  
Augusto César BARRETO NETO
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Abdominal Obesity ◽  
Bowel Disease ◽  
Sedentary Lifestyle ◽  
Excess Weight ◽  
High Frequencies ◽  
Inflammatory Bowel

Background Evidence suggests a nutritional transition process in patients with inflammatory bowel disease. Obesity, which was once an uncommon occurrence in such patients, has grown in this population at the same prevalence rate as that found in the general population, bringing with it an increased risk of cardiovascular disease. Objective The aim of the present study was to determine the nutritional status and occurrence of cardiovascular risk factors in patients with inflammatory bowel disease. Methods A case-series cross-sectional study was conducted involving male and female adult outpatients with inflammatory bowel disease. Data were collected on demographic, socioeconomic, clinical and anthropometric variables as well as the following cardiovascular risk factors: sedentary lifestyle, excess weight, abdominal obesity, medications in use, comorbidities, alcohol intake and smoking habits. The significance level for all statistical tests was set to 5% (P< 0.05). Results The sample comprised 80 patients with inflammatory bowel disease, 56 of whom (70.0%) had ulcerative colitis and 24 of whom (30.0%) had Crohn's disease. Mean age was 40.3±11 years and the female genre accounted for 66.2% of the sample. High frequencies of excess weight (48.8%) and abdominal obesity (52.5%) were identified based on the body mass index and waist circumference, respectively, in both groups, especially among those with ulcerative colitis. Muscle depletion was found in 52.5% of the sample based on arm muscle circumference, with greater depletion among patients with Crohn’s disease (P=0.008). The most frequent risk factors for cardiovascular disease were a sedentary lifestyle (83.8%), abdominal obesity (52.5%) and excess weight (48.8%). Conclusion The results of the complete anthropometric evaluation draw one’s attention to a nutritional paradox, with high frequencies of both - muscle depletion, as well as excess weight and abdominal obesity.

scholarly journals P473 Ustekinumab and vedolizumab influence on cardiovascular risk factors in patients with Inflammatory Bowel Disease

2021 ◽  
Vol 15 (Supplement_1) ◽  
pp. S462-S463
Author(s):  
C Amiama Roig ◽  
C Suárez Ferrer ◽  
J Poza Cordón ◽  
J L Rueda García ◽  
M Sánchez Azofra ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Cardiovascular Risk ◽  
Lipid Profile ◽  
Cardiovascular Risk Factors ◽  
Bowel Disease ◽  
Clinical Remission ◽  
Number Of Patients ◽  
Inflammatory Bowel ◽  
One Year

Abstract Background Chronic inflammatory diseases, including the Inflammatory Bowel Disease (IBD), show an increased risk in the development of atherosclerotic cardiovascular disease and coronary microvascular dysfunction at an early age. AntiTNF α have proven to be effective in reducing the cardiovascular risk in these malaises, nevertheless due to their mechanism of action, we cannot determine whether such efficacy is due to an adequate inflammation control or due to the specific cytokine blockade, which plays an important role in both the inflammation and the atherogenic process. Taking this into account, our hypothesis assesses whether using other anti-inflammatory therapies, such as Ustekinumab and Vedolizumab, would achieve a decrease in cardiovascular risk. Methods In this observational and retrospective study, we collected cardiovascular risk factors(CVRFs) in 46 patients, immediately before starting Ustekinumab or Vedolizumab and a year after, taking into account if patients were in clinical remission or not. The CVRFs included were: body mass index (BMI), arterial hypertension, triglycerides values, lipid profile, albumin and C-reactive protein. Results 46 patients were included, 33(71.74%) with Crohn and 13(28.26%) with Ulcerative Colitis. Of the total number of patients 25(54.35%) were treated with Ustekinumab and 21(45.65%) with Vedolizumab. During the follow-up, only one patient(0.02%) presented a new cardiovascular event. Paired student’s t-test were used for data analysis in both treatment groups, comparing the values of the different CVRFs at the baseline and after one year of treatment. When comparing these values according to clinical remission at one year, no statistically significant differences were observed for any of them. BMI and weight values were |24.49(DE 4.58) vs 24.93(DE 4.74) p=0,71| and |70.76kg(DE 13.86) vs 71.38kg(DE 13.33) p=0,85| respectively. As for hypertension, no relevant changes were observed, representing 15.22% of the population at the beginning and 17.39% after one year of treatment. The differences observed in blood glucose values were|86.23(81.87–90.6)mg/dL vs 89.87mg/dL(84.72–95.01) p=0,27|. Regarding the lipid profile, the total cholesterol values were 158.58mg/dL(DE 36.5) and 168.69mg/dL(DE 32.72) p=0.18. HDL at the beginning 44.67mg/dL(DE 11.69) and after one year 47.43mg/dL(DE 10.19) p=0.28 and triglycerides values of 126.65mg/dL(DE 56.38) and 133.5mg/dL(DE 60.95) p=0,61. Albumin levels|4.08g/dL(DE 0.39) vs 4.27g/dL(DE 0.27)|did show significant differences (p=0,01). Conclusion Patients treated with Vedolizumab or Ustekinumab do not present a significative reduction in the cardiovascular risk after one year regardless of clinical remission.

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