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Inflammatory bowel disease and associated cardiovascular disease outcomes: A systematic review
Vikash Jaiswal1, Nitya Batra2, Mehak Dagar3
1Larkin Community Hospital, South Miami, FL.
Insights
Patients with inflammatory bowel disease (IBD) face increased risks of cardiovascular disease (CVD) events and mortality, particularly women. Lifestyle changes like improved nutrition and exercise are key for CVD prevention in IBD patients.
Area of Science:
- Cardiology
- Gastroenterology
- Public Health
Background:
- Limited and conflicting data exist on cardiovascular disease (CVD) outcomes in inflammatory bowel disease (IBD) patients.
- IBD encompasses chronic inflammatory conditions like ulcerative colitis (UC) and Crohn's disease (CD).
- Understanding IBD's impact on cardiovascular health is crucial for patient management.
Approach:
- A systematic literature review was conducted using major databases (PubMed, Embase, Cochrane, Scopus) up to May 2022.
- Included 16 studies encompassing 2,029,941 patients with IBD.
- Analyzed cardiovascular outcomes, mortality, risk factors, and comorbidities in the IBD population.
Key Points:
- IBD patients exhibit higher risks for adverse cardiovascular outcomes, including myocardial infarction, heart failure, and stroke.
- Common comorbidities in IBD patients include hypertension, diabetes mellitus, dyslipidemia, and previous CVD.
- Smoking and alcohol consumption were identified as prevalent risk factors for CVD in this cohort.
Conclusions:
- Inflammatory bowel disease is associated with an elevated risk of cardiovascular events and mortality, especially in female patients.
- Current treatment lacks specific algorithms for assessing and managing CVD risk in IBD.
- Prioritizing nutritional modifications and physical activity is essential for cardiovascular disease prevention in individuals with IBD.
Background:
There is limited and conflicting data available regarding the cardiovascular disease outcomes associated with inflammatory bowel disease (IBD).
Objective:
We aim to perform a systematic review to evaluate the cardiovascular outcomes and mortality associated with IBD patients.
Methods:
A systematic literature search has been performed on PubMed, Embase, Cochrane, and Scopus from inception till May 2022 without any language restrictions.
Results:
A total of 2,029,941 patients were included in the analysis from 16 studies. The mean age of the patients was 45.6 years. More females were found compared with males (57% vs 43%). The most common risk factors for cardiovascular disease (CVD) included smoking (24.19%) and alcohol (4.60%). The most common comorbidities includes hypertension (30%), diabetes mellitus (14.41%), dyslipidemia (18.42%), previous CVD (22%), and renal disease (10%). Among outcomes, all-cause mortality among IBD patients was 1.66%; ulcerative colitis (UC): 15.92%; and Crohn disease (CD): 0.30%. Myocardial Infarction (MI) among IBD patients were 1.47%, UC: 30.96%; and CD: 34.14%. CVD events among IBD patients were 1.95%. Heart failure events among IBD patients were 5.49%, stroke events among IBD patients were 0.95%, UC: 2.63%, and CD: 2.41%, respectively.
Conclusion:
IBD patients are at higher risk for adverse cardiovascular outcomes, especially in women. Although there remains a lack of concrete treatment algorithms and assessment parameters that better characterize IBD risk factors, nutritional modifications and physical activity should be at the forefront of CVD prevention in IBD.
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