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Thromboembolic complications and cardiovascular events associated with celiac disease

Fotios S Fousekis1, Eleni T Beka1, Ioannis V Mitselos1

  • 1Department of Gastroenterology and Hepatology, School of Health Sciences, Faculty of Medicine, University Hospital of Ioannina, University of Ioannina, POBox 1186, 45110, Ioannina, Greece.

Irish Journal of Medical Science
|July 22, 2020
PubMed

Insights

Celiac disease (CD) increases the risk of cardiovascular events and thromboembolism. A gluten-free diet may reduce these serious complications in patients with CD.

Area of Science:

  • Immunology
  • Gastroenterology
  • Cardiology

Background:

  • Celiac disease (CD) is an immune-mediated intestinal disorder triggered by gluten exposure in susceptible individuals.
  • Beyond gastrointestinal symptoms, CD is linked to various extraintestinal manifestations, notably cardiovascular issues and thromboembolism.
  • Patients with CD exhibit an elevated risk for conditions such as ischemic stroke, myocardial infarction, deep vein thrombosis, and pulmonary embolism.

Purpose of the Study:

  • To highlight the association between celiac disease and an increased risk of thromboembolic and cardiovascular complications.
  • To discuss the multifactorial pathogenetic mechanisms underlying hypercoagulability in celiac disease.
  • To emphasize the importance of considering celiac disease in unexplained thromboembolic and cardiovascular cases.

Main Methods:

  • Review of existing literature on celiac disease and its association with cardiovascular and thromboembolic events.
  • Analysis of pathogenetic factors contributing to hypercoagulability in celiac disease patients.
  • Clinical observation and case study analysis.

Main Results:

  • Celiac disease patients demonstrate a significantly higher incidence of ischemic stroke, myocardial infarction, deep vein thrombosis, and pulmonary embolism.
  • Evidence suggests that adhering to a gluten-free diet can mitigate the risk of these cardiovascular and thromboembolic complications.
  • The underlying mechanisms include hyperhomocysteinemia, endothelial dysfunction, accelerated atherosclerosis, chronic inflammation, thrombocytosis, and thrombophilia.

Conclusions:

  • Celiac disease is associated with a heightened risk of serious thromboembolic and cardiovascular events.
  • A gluten-free diet is crucial for managing and potentially reducing these risks in celiac disease patients.
  • Clinicians should maintain a high index of suspicion for celiac disease in patients presenting with unexplained thromboembolic or cardiovascular disease.

Keywords:
AtherosclerosisCeliac diseaseExtra-intestinal manifestationsHypercoagulabilityThromboembolism

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