Tu1285 Increased Risk of Coronary Artery Disease Among Patients With Inflammatory Bowel Disease

Inamdar, Sumant; Altafi, Soheil; Simfukwe, Keith

doi:10.1016/s0016-5085(12)63078-9

Cited by 8 publications

(9 citation statements)

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“…54 The other three studies have reported significantly lower rates of risk factors such as hypertension, diabetes, dyslipidemia, obesity, or the composite Framingham risk score than in the control population. 49,53,57 If this is a generalizable finding, then cardiovascular risk associated with IBD itself should be corrected for the traditional risks. In fact, the two studies doing this found the HR for coronary arterial events nearly doubled with such a correction.…”

Section: Discussionmentioning

confidence: 99%

“…In short, cigarette smoking exerts its effects through oxidative stress, hyperglycemia through the genesis of advanced glycation products and hypertension through shear stress, all of which cause endothelial dysfunction and/or inflammation, the details of which are beyond the scope of this review . As outlined above, the three of the four studies that have addressed standard cardiovascular risk factors for atherosclerosis in patients with IBD reported significantly reduced prevalence and/or considerably reduced Framingham Risk Score . The reasons for such a reduced risk are at present unknown, but the authors suggest it may in part be related to the younger age of onset of ATE disease in IBD patients.…”

Section: Pathogenic Mechanismsmentioning

confidence: 97%

“…If this is a generalizable finding, then cardiovascular risk associated with IBD itself should be corrected for the traditional risks. In fact, the two studies doing this found the HR for coronary arterial events nearly doubled with such a correction …”

Section: The Extent Of the Problemmentioning

confidence: 97%

“…Only one study found significantly higher rates of cardiovascular risk factors in IBD subjects versus controls, but the IBD cohort study was significantly older than the control cohort . The other three studies have reported significantly lower rates of risk factors such as hypertension, diabetes, dyslipidemia, obesity, or the composite Framingham risk score than in the control population . If this is a generalizable finding, then cardiovascular risk associated with IBD itself should be corrected for the traditional risks.…”

Section: The Extent Of the Problemmentioning

confidence: 98%

“…The highest ATE risks are seen with mesenteric ischemia, where risks are between 3.4 and 11.2 higher than controls . In terms of coronary artery disease, ischemic heart disease and myocardial infarction, five studies reported an increased risk ranging from 1.22–2.85 higher than controls . In contrast, one study that examined the risk of first‐time myocardial infarction in IBD subjects, found no association, and another in which cardiovascular events in hospitalized subjects were reviewed, found an inverse risk .…”

Section: The Extent Of the Problemmentioning

confidence: 99%

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Venous and arterial disease in inflammatory bowel disease

Tan

Chung

Yan

et al. 2013

J of Gastro and Hepatol

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Awareness is increasing that risk of venous thromboembolism and development of atherosclerosis is elevated in patients with some chronic inflammatory diseases. This review aimed to examine the risk of vascular disease in patients with inflammatory bowel disease (IBD) and to identify potential pathogenic mechanisms and therapeutic approaches. An extensive literature search was conducted using MEDLINE database, Cochrane Library and international conference abstracts for studies pertaining to venous and arterial thromboembolism in adult IBD patients. There is a 1.1–3.6 fold risk of venothromboembolism in IBD, affecting 0.55–6.15% of patients. Risks are increased during a flare or with chronically active inflammation. Evidence is building that there may be a modestly increased risk of arterial disease overall, despite evidence that traditional risk factors may be reduced. Multiple pathogenic factors have been identified including endothelial dysfunction, inflammation‐mediated calcium deposition in the media of arteries, hyperhomocysteinemia, platelet activation, and altered coagulation and fibrinolysis. The key to active and preventive therapy is to effectively treat inflammation. Recommendations for prophylaxis of venothromboembolism have followed guidelines where they exist and have been extrapolated from studies of other at‐risk conditions, as have those for arterial disease, where screening for risk factors and actively treating abnormalities is encouraged. In conclusion, patients with IBD are at considerably increased risk of venothromboembolism and probably of arterial disease, in particular mesenteric ischemia and ischemic heart disease. Increased penetration of gaps between this knowledge and clinical therapeutic action to prevent thromboembolic events into IBD clinical practice is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Pathogenic Mechanismsmentioning

confidence: 97%

Section: The Extent Of the Problemmentioning

confidence: 97%

Section: The Extent Of the Problemmentioning

confidence: 98%

Section: The Extent Of the Problemmentioning

confidence: 99%

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