Abstract
Several studies have shown increased rates of cardiovascular disease (CVD) in patients suffering from inflammatory bowel disease (IBD), particularly in cases of early atherosclerosis and myocardial infarction. IBD most frequently begins at an early age, patients usually present normal weight and remain under constant care of a physician, as well as of a nutritionist. Therefore, the classical risk factors of CVD are not reflected in the higher prevalence of CVD in the IBD population. Still, both groups are characterised by chronic inflammation and display similar physiopathological mechanisms. In the course of IBD, increased concentrations of pro-inflammatory cytokines, such as C-reactive protein (CRP) and homocysteine, may lead to endothelial dysfunctions and the development of CVD. Furthermore, gut microbiota dysbiosis in patients with IBD also constitutes a risk factor for an increased susceptibility to cardiovascular disease and atherosclerosis. Additionally, diet is an essential factor affecting both positively and negatively the course of the aforementioned diseases, whereas several dietary patterns may also influence the association between IBD and CVD. Thus, it is essential to investigate the factors responsible for the increased cardiovascular (CV) risk in this group of patients. Our paper attempts to review the role of potential inflammatory and nutritional factors, as well as intestinal dysbiosis and pharmacotherapy, in the increased risk of CVD in IBD patients.
Highlights
According to recent studies, patients with inflammatory bowel disease (IBD) present an increased risk of developing cardiovascular diseases (CVD); there is relatively little literature data regarding the relationship between IBD and CVD
This study showed that IBD was associated with a lower risk of in-hospital complications following percutaneous coronary intervention (PCI) other than severe haemorrhage [41], which indicates that appropriate and effective treatment of IBD may be the basis for reducing the risk of acute coronary syndromes (ACS) and reducing complications after PCI
There is a lack of evidence defining cardiovascular disease prevention in patients with IBD
Summary
Patients with inflammatory bowel disease (IBD) present an increased risk of developing cardiovascular diseases (CVD); there is relatively little literature data regarding the relationship between IBD and CVD. Several studies have suggested that the risk of acute cardiac injury mortality is lower among patients with IBD when compared with non-IBD patients It could be explained by the fact that patients with IBD may respond to the pro-inflammatory cytokines released during cardiac arrest due to the chronic inflammation associated with the underlying disease [37]. They conducted a cohort analysis of the association between IBD, disease activity and the risk of myocardial infarction, stroke and cardiovascular death. They did not find a significant increase in vascular events in patients with IBD in general, the study demonstrated that the incidence of the events correlated with a higher disease activity [40]. Intervention (PCI) other than severe haemorrhage [41], which indicates that appropriate and effective treatment of IBD may be the basis for reducing the risk of ACS and reducing complications after PCI
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