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The role of coexisting cardiovascular disease on disease severity in patients with inflammatory bowel disease
Aikaterini Mantaka1,2, Emmanouela Tsoukali1,3, Maria Fragkaki4
1Faculty of Medicine, University of Crete, Heraklion.
Insights
Inflammatory bowel disease (IBD) patients with cardiovascular disease (CVD) do not show more severe IBD. Traditional CVD risk factors were more common in IBD patients with CVD, suggesting inflammation may play a lesser role.
Area of Science:
- Gastroenterology
- Cardiology
- Immunology
Background:
- Chronic inflammation is linked to atherosclerosis and cardiovascular disease (CVD).
- Limited data exist on the relationship between inflammatory bowel disease (IBD) severity and coexisting CVD.
Purpose of the Study:
- To investigate if IBD patients with coexisting CVD exhibit more severe IBD.
- To compare traditional CVD risk factors and IBD severity markers between IBD patients with and without CVD.
Main Methods:
- A comparative study of 103 IBD patients with CVD and 206 IBD patients without CVD.
- Analysis of IBD severity markers (surgeries, hospitalizations, medication use, CRP levels) and traditional CVD risk factors.
Main Results:
- No significant difference in IBD severity markers between IBD patients with and without CVD.
- Traditional CVD risk factors were more prevalent in IBD patients with CVD.
- IBD patients with CVD showed a trend towards lower rates of hospitalizations and surgeries.
Conclusions:
- Inflammatory burden may play a less significant role in CVD development among IBD patients.
- Larger prospective studies are required to confirm these findings.
Objectives:
Chronic inflammation has been implicated in the pathogenesis of atherosclerosis and cardiovascular disease. Data linking the severity of inflammatory bowel disease to coexisting cardiovascular disease are scarce. The aim of the present study was to investigate whether inflammatory bowel disease patients with coexistent cardiovascular disease have more severe disease.
Methods:
We included 103 inflammatory bowel disease patients with coexisting cardiovascular disease compared to 206 age- and sex-matched inflammatory bowel disease patients without cardiovascular disease derived from three referral inflammatory bowel disease Centers. Traditional cardiovascular disease factors and parameters of inflammatory bowel disease severity were compared between the two groups.
Results:
Cardiovascular disease was diagnosed after the inflammatory bowel disease diagnosis in 56.6% of cases. No significant difference was found in the prevalence of surrogate markers of severity (inflammatory bowel disease-related surgeries, hospitalizations, biologics or immunosuppressants' use, and persistent CRP elevation) between inflammatory bowel disease patients with and without cardiovascular disease. There was no difference between cardiovascular disease patients diagnosed before and after inflammatory bowel disease onset. All traditional risk factors (hypertension, dyslipidemia, smoking, obesity, diabetes mellitus) were significantly more common in cardiovascular disease patients. Cardiovascular disease patients had a trend for lower rates of multiple hospitalizations (16.5% vs. 24.3%, P = 0.05) and inflammatory bowel disease-related surgeries (P = 0.09).
Conclusion:
The inflammatory burden possibly plays a less important role in the development of cardiovascular disease in inflammatory bowel disease patients but future larger prospective studies are needed.
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