Kondubhatla Kaushik, Kaushal Ayush, Daoud Ali, Shabbir Hassan, Mostafa Jihan A
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Psychiatry and Behavioral Sciences, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Cureus. 2020 Sep 19;12(9):e10544. doi: 10.7759/cureus.10544.
Inflammatory bowel disease (IBD), comprising ulcerative colitis and Crohn's disease, is characterized by widespread inflammation of the gastrointestinal tract with systemic manifestations. Inflammation is one of the driving forces for the pathogenesis of atherosclerosis and its dreaded complications like myocardial infarction (MI). Yet, the association between IBD and myocardial infarction has not been thoroughly established. Myocardial infarction in IBD patients was predominantly seen in young women during the active disease process. At the same time, elevated levels of C-reactive protein and other pro-inflammatory markers were observed in both IBD and atherosclerosis. Increasing evidence suggests inflammation inhibits fibrinolysis, expresses procoagulants, and suppresses anticoagulants promoting thrombosis formation. Moreover, the alteration of gut microbiota impacts the pathogenesis of inflammation and predisposes one to ischemic heart disease. Accordingly, all IBD patients should be screened and counseled on lifestyle modifications for the traditional risk factors of atherosclerosis. Future researchers should consider conducting more clinical trials on anti-inflammatory medication targeting atherosclerosis and therapeutics, while targeting the gut microbiota to reverse the inflammatory atherosclerotic process.
炎症性肠病（IBD）包括溃疡性结肠炎和克罗恩病，其特征是胃肠道广泛炎症并伴有全身表现。炎症是动脉粥样硬化及其可怕并发症（如心肌梗死（MI））发病机制的驱动因素之一。然而，IBD与心肌梗死之间的关联尚未完全确立。IBD患者的心肌梗死主要发生在疾病活动期的年轻女性中。同时，在IBD和动脉粥样硬化患者中均观察到C反应蛋白及其他促炎标志物水平升高。越来越多的证据表明，炎症会抑制纤维蛋白溶解、表达促凝剂并抑制抗凝剂，从而促进血栓形成。此外，肠道微生物群的改变会影响炎症的发病机制，并使人易患缺血性心脏病。因此，所有IBD患者都应接受筛查，并就动脉粥样硬化传统危险因素的生活方式改变接受咨询。未来的研究人员应考虑针对动脉粥样硬化和治疗方法开展更多关于抗炎药物的临床试验，同时针对肠道微生物群来逆转炎症性动脉粥样硬化进程。
