Inflammatory Bowel Disease and Risk of Ischemic Heart Disease: An Updated Meta‐Analysis of Cohort Studies

Abstract

BackgroundSeveral immune‐mediated diseases have been shown to be associated with an increased risk of cardiovascular disease. However, studies evaluating the association between inflammatory bowel disease and risk of cardiovascular disease reported inconsistent results. We assessed the association between inflammatory bowel disease and risk of ischemic heart disease in a meta‐analysis of cohort studies.Methods and ResultsWe conducted a literature search of PubMed and Embase up to October 2016 to identify relevant studies. The summary relative risks were calculated using the random‐effects models. To explore the source of heterogeneity, we performed subgroup and sensitivity analysis. We included 10 cohort studies that satisfied our inclusion criteria. Patients with inflammatory bowel disease were associated with an increased risk of ischemic heart disease (relative risk: 1.244; 95% CI, 1.142–1.355). Considerable heterogeneity was observed. Crohn's disease showed a significantly increased risk of ischemic heart disease (relative risk=1.243; 95% CI, 1.042–1.482) and a positive association was also observed in ulcerative colitis (relative risk=1.206; 95% CI, 1.170–1.242).ConclusionsBased on meta‐analysis of cohort studies, we found an increased risk of ischemic heart disease in patients with inflammatory bowel disease. Large long‐term prospective studies are warranted to confirm our results.

Patients with inflammatory bowel disease have an increased risk of myocardial infarction: a nationwide study

“…Two meta‐analyses concluded that cardio/cerebrovascular risk is increased in IBD, particularly among women, which is in accordance with our present results. The larger effect noted in female IBD patients might be related to the fact that the role of inflammation in coronary heart disease seems to be greater in women than in men.…”

“…In terms of age and risk, more prominent association of IBD with increased CVD risk in younger patients (vs older patients) has been consistently reported . Consistently, we found that, among CD patients, the magnitude of the increase in cardiovascular risk is higher in younger individuals (<40 vs ≥40 years, especially <30 years old), which may be related to inflammation levels.…”

“…It suggested that the difference in the inflammatory burden and inflammatory biology between CD and UC may be related with atherosclerosis or thrombotic events . Compared to UC, CD is associated with a greater C‐reactive protein response and usually a worse disease course, which may explain the stronger association of CD with cardio/cerebrovascular events, as reported in most studies . Polymorphisms in NOD2 that predispose to CD have also been associated with atherosclerosis, which suggests a potential common genetic basis for these two diseases .…”

Relationship(s) between obesity and inflammatory bowel diseases: possible intertwined pathogenic mechanisms

“…The risk was higher in younger women less than 50 years old. In sub-analyses, controlling for obesity or smoking did not influence the outcome [125]. In a smaller retrospective controlled cohort study spanning 30 years from Olmsted county, USA, the risk for both acute myocardial infarct (CD and UC) and heart failure (UC) was found to be increased.…”

Aterosclerose subclínica medida pelo escore de cálcio coronariano e avaliação da HDL em pacientes com doença de Crohn

“…Assim como outras doenças crônicas imunomediadas, a DC também está associada a uma maior incidência de eventos CV (DAC, AVE, doença arterial periférica e isquemia mesentérica), independentemente da presença dos fatores de risco clássicos para aterosclerose [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] . Diversas coortes retrospectivas realizadas por meio de grandes bases de dados populacionais, com envolvimento de até cerca de 150.000 pacientes com DC, evidenciam risco de doença isquêmica do miocárdio aumentado em até 31% em relação à população geral 20,22,26,27,34 .…”