Department of Medicine, University of Arizona, Phoenix, AZ, United States.
Department of Medicine, University of Miami at Holy Cross Hospital, Fort Lauderdale, FL, United States.
Trends Cardiovasc Med. 2020 Nov;30(8):463-469. doi: 10.1016/j.tcm.2019.10.001. Epub 2019 Oct 11.
Inflammation has a strong role in the development of atherosclerotic cardiovascular disease (ASCVD). Several systemic inflammatory conditions have been linked to an increased risk of ASCVD; however, this has not been well established in Inflammatory Bowel Disease (IBD). IBD is comprised of Ulcerative Colitis and Crohn's disease, both of which involve chronic inflammation of the intestinal tract, often with evidence of systemic involvement. Several ASCVD risk factors such as smoking, diabetes, poor diet and the presence of obesity may increase the risk of ASCVD in patients suffering from IBD, despite a lower prevalence of hypertension and hypercholesterolemia. Medications used to treat IBD and target inflammation, such as steroids, may also accelerate the risk of the risk for ASCVD heart failure while exacerbating ASCVD risk factors. Several studies have demonstrated an elevated risk of acute myocardial infarction and stroke in these patients, most notably in women and in younger patients. Some cohort studies have also suggested a link between IBD and both atrial fibrillation and heart failure, particularly during periods of active flares. All IBD patients, particularly younger individuals, should be screened for ASCVD risk factors with aggressive risk factor modification to reduce the risk of cardiovascular events. Further research is needed to identify how to prevent and treat cardiovascular events that occur in patients with IBD, particularly during active flares.
炎症在动脉粥样硬化性心血管疾病（ASCVD）的发展中起着重要作用。一些全身性炎症性疾病与 ASCVD 风险增加有关；然而，这在炎症性肠病（IBD）中尚未得到充分证实。IBD 包括溃疡性结肠炎和克罗恩病，两者都涉及肠道的慢性炎症，通常伴有全身受累的证据。一些 ASCVD 风险因素，如吸烟、糖尿病、不良饮食和肥胖的存在，可能会增加 IBD 患者患 ASCVD 的风险，尽管高血压和高胆固醇血症的患病率较低。用于治疗 IBD 并靶向炎症的药物，如类固醇，也可能加速 ASCVD 心力衰竭的风险，同时加剧 ASCVD 的风险因素。几项研究表明，这些患者的急性心肌梗死和中风风险增加，尤其是在女性和年轻患者中。一些队列研究还表明，IBD 与房颤和心力衰竭之间存在关联，特别是在活动期发作期间。所有 IBD 患者，尤其是年轻患者，应筛查 ASCVD 风险因素，并积极进行危险因素改变，以降低心血管事件的风险。需要进一步研究以确定如何预防和治疗 IBD 患者发生的心血管事件，特别是在活动期发作期间。
