Abstract
Abstract Background The axiom which defines that the high prevalence of cardiovascular risk factors is by definition correlated with the risk of cardiovascular events does not seem to apply to subjects with IBD, according to several studies which have reported that the prevalence of classic cardiovascular risk factors is lower in subjects with IBD than in the general population. This leads us to look for other markers to identify this risk at an early stage. The Augmentation index (Aix) is one such marker, based on the reflection of the pulse wave in the blood, and is a recognised measure of arterial stiffness and a risk factor for cardiovascular disease Methods This was a prospective cross-sectional study of 107 patients with Crohn’s disease (CD) diagnosed on the basis of clinical, endoscopic, morphological and histological criteria. Classical cardiovascular risk factors were analysed, as well as data concerning CD: duration, location, phenotype, clinical relapse, extradigestive manifestations, ano-perineal lesions (APL) and C-reactive protein (CRP). The augmentation index (Aix) was assessed using the SphygmoCor-XCEL Sydney. The Chi2 test was used for qualitative variables and the Kruskal Wallis test for quantitative variables. The informed consent of all patients was obtained. Results 57.9% were men, mean age was 36.9 ± 11.7 years, 5.6% of patients had coronary heredity, 11.2% hypertensive, mean systolic blood pressure: 120.1 ± 12.7 mm/hg, mean diastolic blood pressure: 74.4 ± 8.1 mm/hg, pulse pressure: 45.7 ±9.3 mm/hg, AIx was positive in 31.8% of patients, 7.5% of women were postmenopausal, mean BMI was 22 ± 5.91 Kg/m2, 9.3% were obese, 11.2% were sedentary, 20.6% were active smokers, only two patients were diabetic. 57.9% had dyslipidaemia, and 13.1% had a low cardiovascular risk according to the Framingham score. 74% had an ileal location, 6.8% colonic and 19.2% ileocolic, 19.8% had an inflammatory form, 43,4% stenosing and 36,8% penetrating, 25.5% with ano-perineal lesions, 31.4% had an extradigestive manifestation, 59.4% of patients were in clinical relapse, 47.2% of whom had a CRP > 6mg/l, 38% of subjects had had at least one relapse in the year prior to recruitment, and the mean duration of the disease was 57.3 ± 57 months. Statistical analysis showed a significant association between AIx and clinical relapse (p=0.03), disease duration (p=0.008), and no significant association with phenotype, location, APL, extradigestive manifestations and CRP (p>0.05). Conclusion Our results suggest that the augmentation index could be a good tool for detecting subclinical cardiovascular damage in Crohn’s disease. Clinical relapse and the duration of the disease would be two predominant factors in the increase in this index
Published Version
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