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Atherosclerotic Cardiovascular Disease in Inflammatory Bowel Disease: The Role of Chronic Inflammation and Platelet
Sofija I Lugonja1, Ivana L Pantic2, Tamara M Milovanovic2,3
1Division of Gastroenterology, Department of Internal Medicine, General Hospital "Djordje Joanovic", 5 Dr. Vase Savica Street, 23000 Zrenjanin, Serbia.
Insights
Inflammatory markers and platelet aggregation are elevated in ulcerative colitis patients, indicating a higher risk for atherosclerosis. These markers can help identify patients with ulcerative colitis at greatest risk for this cardiovascular condition.
Area of Science:
- Cardiovascular Medicine
- Gastroenterology
- Immunology
Background:
- Atherosclerosis is a major cardiovascular complication of inflammatory bowel disease.
- Understanding the link between ulcerative colitis and atherosclerosis is crucial for patient management.
Purpose of the Study:
- To investigate the association between biochemical, hemostatic, and immune markers of atherosclerosis in ulcerative colitis (UC) patients.
- To explore the relationship between these markers and platelet aggregation in UC patients.
Main Methods:
- A cross-sectional observational study comparing four groups: UC with atherosclerosis, UC without atherosclerosis, atherosclerosis without UC, and healthy controls.
- Analysis of inflammatory markers (e.g., SE, CRP, TNF-α, IL-6, fecal calprotectin), lipid profiles, thrombocytes, and platelet aggregation.
Main Results:
- Patients with UC exhibited higher levels of inflammatory markers and platelet aggregation compared to controls.
- Lower total cholesterol and LDL were observed in UC patients (with or without atherosclerosis) versus healthy controls.
- Triglyceride and remnant cholesterol levels varied, being higher in UC with atherosclerosis compared to UC alone and healthy controls, but lower than in atherosclerosis alone.
Conclusions:
- Elevated inflammatory markers and heightened platelet aggregation serve as potential discriminators for identifying UC patients at high risk of atherosclerosis.
- These findings highlight the interplay between inflammation, coagulation, and cardiovascular risk in ulcerative colitis.
Abstract:
Background and Objectives: Atherosclerosis is one of inflammatory bowel disease's most significant cardiovascular manifestations. This research aimed to examine the relationship between biochemical, haemostatic, and immune parameters of atherosclerosis and ulcerative colitis patients and its relationship to platelet aggregation. Materials and Methods: A clinical, observational cross-sectional study was performed, during which the tested parameters were compared in the experimental and control groups. The patients were divided into four groups. The first group had 25 patients who had ulcerative colitis and atherosclerosis. The second group included 39 patients with ulcerative colitis without atherosclerosis. The third group comprised 31 patients suffering from atherosclerosis without ulcerative colitis, and the fourth group comprised 25 healthy subjects. Results: In our study, we registered statistically higher levels of inflammatory markers like SE, CRP, Le, fecal calprotectin, TNF-α, and IL-6, as well as the higher value of thrombocytes and thrombocyte aggregation in the group of patients with ulcerative colitis compared to the control group. Lower levels of total cholesterol and LDL were also recorded in patients with ulcerative colitis and atherosclerosis and ulcerative colitis without atherosclerosis compared to healthy control. Triglyceride and remnant cholesterol were higher in patients with ulcerative colitis and atherosclerosis when compared to patients with ulcerative colitis and healthy control but lower than in patients with atherosclerosis only. Conclusions: Several inflammatory markers and platelet aggregation could be good discrimination markers for subjects with ulcerative colitis with the highest risk of atherosclerosis.
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