Inflammatory Bowel Disease and Associated Cardiovascular Disease Outcomes: A Systematic Review

Abstract

BACKGROUND There is limited and conflicting data available regarding the Cardiovascular disease outcomes associated with Inflammatory Bowel Disease (IBD) OBJECTIVE We aim to perform a systematic review to evaluate the cardiovascular outcomes and mortality associated with IBD patients. METHODS A systematic literature search has been performed on PubMed, Embase, Cochrane, and Scopus from inception till May 2022 without any language restrictions. RESULTS A total of 2,029,941 patients were included into the analysis from 16 studies. The mean age of the patients was 45.6 years. More females were found compared with males (57% vs 43%). The most common risk factors for Cardiovascular disease (CVD) included smoking (24.19%) and alcohol (4.60%). The most common co-morbidities included hypertension (30%), diabetes mellitus (14.41%), dyslipidemia (18.42%), previous CVD (22%), and renal disease (10%). Among outcomes All-cause mortality among IBD patients was 1.66%; Ulcerative Colitis (UC): 15.92%; and Crohn’s disease (CD): 0.30%. Myocardial Infarction (MI) among IBD patients were 1.47%, among UC: 30.96%; and among CD: 34.14%. Cardiovascular Death (CVD) events among IBD patients were 1.95%. Heart failure events among IBD patients were 5.49%, while Stroke events among IBD Patients were 0.95%; among UC: 2.63%; and CD: 2.41% respectively. CONCLUSION There was a possible association between IBD patients and adverse cardiovascular outcomes especially in young and females. Though there remains a lack of concrete treatment algorithms and assessment parameters that better characterize IBD risk factors, nutritional modifications and physical activity should be at the fore-front of CVD prevention in IBD.