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 in 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 comorbidities includes 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 disease (CD): 0.30%. Myocardial Infarction (MI) among IBD patients were 1.47%, UC: 30.96%; and CD: 34.14%. CVD events among IBD patients were 1.95%. Heart failure events among IBD patients were 5.49%, stroke events among IBD patients were 0.95%, UC: 2.63%, and CD: 2.41%, respectively. Conclusion: IBD patients are at higher risk for adverse cardiovascular outcomes, especially in women. Although 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 forefront of CVD prevention in IBD.

Cardiovascular disease: extraintestinal manifestation of inflammatory bowel disease

“…This leads to plaque destabilization, increased risk of rupture, and subsequent thrombosis. 37,38 Increased levels of these proinflammatory cytokines, along with elevated levels of CRP and homocysteine, result in accompanying changes in glucose and lipid metabolism, leading to increased LDL, triglycerides, insulin resistance, and decreased HDL. These alterations in the body increase the likelihood of developing ASCVD, obesity, and diabetes (Fig.…”

Navigating the Gut-Cardiac Axis: Understanding Cardiovascular Complications in Inflammatory Bowel Disease

“…IBD patients face an increased risk of CVCs, notably CAD. This heightened risk encompasses both UC and CD patients, with studies consistently showing a higher risk compared to the general population [13,15,16]. Notably, IBD patients also exhibit an increased risk of angina, MI, and HF stemming from CAD, highlighting the systemic impact of chronic inflammation beyond the gut [12,17].…”

“…According to a systematic review by Jaiswal et al, myocardial infarction (MI) occurred in 1.47% of IBD patients, while in UC and CD patients, it occurred at the rates of 30.96% and 34.14%, respectively. Cardiovascular disease events were observed in 1.95% of IBD patients [13]. Incidences of heart failure were recorded at 5.49% of IBD patients.…”

“…Incidences of heart failure were recorded at 5.49% of IBD patients. Stroke events were noted at 0.95% for IBD patients, while in UC and CD patients, it occurred at the rates of 2.63% and 2.41%, respectively [13]. It has also been demonstrated that women particularly face an elevated risk of adverse cardiovascular outcomes among IBD patients [13,14].…”

Efficacy and Safety of Biological Therapies and JAK Inhibitors in Older Patients with Inflammatory Bowel Disease

“…Generic risk assessment tools, e.g., the SCORE2-OP score [ 86 ], have been developed for the older population, but no score has ever been validated in UC patients [ 87 ]. IBD patients, above all, have an increased cardiovascular risk [ 88 ].…”