Prognosis After First-Time Myocardial Infarction in Patients With Inflammatory Bowel Disease According to Disease Activity

Abstract

Background-Inflammatory bowel disease (IBD) is associated with increased cardiovascular risk. We examined the effect of active IBD on major adverse cardiovascular outcomes after myocardial infarction (MI

Low childhood high density lipoprotein cholesterol levels and subsequent risk for chronic inflammatory bowel disease

“…These results are concordant with Canadian and Danish studies that detected an increased coronary artery disease risk in IBD patient cohorts of over 8000 and 28,000 patients, respectively [20,21]. A study from Denmark revealed that active IBD worsened patient's prognosis after myocardial infarction [22]. However, the above-mentioned findings were not confirmed in UK and US studies [23,24].…”

Cardiac leptin overexpression in the context of acute MI and reperfusion potentiates myocardial remodeling and left ventricular dysfunction

“…Furthermore, our mouse model may also simulate clinical scenarios of patients, who experience acute MI and reperfusion coinciding with leptin overexpression associated with a preexisting inflammatory state. Grave consequences attributed to this coupling have been observed in patients suffering from inflammatory bowel disease[ 38 , 39 ] or rheumatoid arthritis[ 40 ], who exhibit disproportional degree of post-MI HF. We further speculate that our model may be analogous to acute MI coinciding with an inflammatory response that is incited by acute infection and sepsis (soft tissue infection, urinary tract infection, upper respiratory infection, or periodontal infection).…”

Vascular Endothelial Dysfunction in Inflammatory Bowel Diseases: Pharmacological and Nonpharmacological Targets

“…In these studies, the induction of the remission is able to reverse endothelial dysfunction in IBD, achieving a level similar to non-IBD subjects. This evidence allows to hypothesize that an adequate medical management of IBD may be able to reverse the increased cardiovascular risk characterizing active disease [ 85 , 86 , 87 ]. Adequate disease management would therefore be important already in childhood; as shown by Ciccone et al, atherosclerosis is a process that can begin in childhood; we should always try to manage patients with IBD well to keep the level of these atherosclerotic factors as always low, because several studies demonstrated presence of a lot of atherosclerotic markers in children affected by IBD [ 79 ].…”

“…Several studies have demonstrated an increased risk of cardiovascular disease in patients with IBD; however, regarding mortality risk, the evidences are less clear. Kristensen et al [ 85 ] did not find an increased risk for CVD in patients with IBD without classic CVD risk factors after a 2-year follow-up. Singh et al [ 88 ], in a meta-analysis of about 33 observational studies, showed a higher risk for ischemic heart disease and arterial thromboembolism in patients with IBD, but the increased risk for cardiovascular mortality was not observed.…”

“…Fumery et al [ 89 ], in a meta-analysis of 9 studies, demonstrated that patients with IBD had a significant increase in the risk of cardiovascular morbidity, particularly in women; however, in this paper, the mortality was not addressed. Kristensen et al [ 85 ], in a cohort study, demonstrated an increased risk of myocardial infarction in patients with IBD during the active phase, whereas no risk was observed in remission. Dorn et al [ 6 ], in a 2007 meta-analysis of 11 studies, failed to demonstrate an increased risk of cardiovascular mortality in patients with IBD.…”