Meda Anish, Fredrick Fremita, Rathod Urvashi, Shah Priyanshi, Jain Rohit
Avalon University School of Medicine, Willemstad, Curacao.
Narendra Modi Medical College, Ahmedabad, India.
Curr Cardiol Rev. 2023 Nov 24;20(1). doi: 10.2174/011573403X256094231031074753.
Inflammatory bowel disease is a group of long-term systemic inflammatory disorders affecting the gastrointestinal tract, including Crohn's disease and ulcerative colitis, which may be associated with an increased risk of developing extraintestinal manifestations, including cardiovascular disease, thereby decreasing the quality of life. Pathophysiological changes associated with inflammatory bowel disease include alterations of the microbiome, endotoxemia, and changes to glucose and lipid metabolism. Inflammatory bowel disease patients have higher carotid intima-media thickness, lower flow-mediated dilatation, and increased carotid-femoral pulse wave velocity, which are markers of elevated cardiovascular risk. In addition, inflammatory bowel disease patients are at an increased risk for developing venous and arterial thrombotic events due to a hypercoagulable state caused by thrombocytosis and coagulation system activation. To reduce the risk of developing cardiovascular disease, lifestyle modifications, such as smoking cessation, dietary changes, and increased physical activity alongside management with appropriate medication, should be considered. This research paper examines how inflammatory bowel disease can influence the risk of cardiovascular complications and the involvement of drug therapy. Methods: PubMed was searched using keywords, such as inflammatory bowel disease, Crohn's disease, ulcerative colitis, cardiovascular disease, pericarditis, thromboembolism, and many more. Relevant literature up to March 2023 has been examined and summarized, which consisted of data from various clinical trials, meta-analyses, retrospective/prospective cohort studies, and current guidelines.
炎症性肠病是一组影响胃肠道的长期全身性炎症性疾病,包括克罗恩病和溃疡性结肠炎,可能会增加发生肠外表现(包括心血管疾病)的风险,从而降低生活质量。与炎症性肠病相关的病理生理变化包括微生物群改变、内毒素血症以及葡萄糖和脂质代谢变化。炎症性肠病患者的颈动脉内膜中层厚度更高、血流介导的扩张更低,且颈动脉-股动脉脉搏波速度增加,这些都是心血管风险升高的标志物。此外,由于血小板增多症和凝血系统激活导致的高凝状态,炎症性肠病患者发生静脉和动脉血栓事件的风险增加。为降低发生心血管疾病的风险,应考虑进行生活方式的改变,如戒烟、饮食调整和增加体育活动,并同时使用适当的药物进行治疗。本研究论文探讨了炎症性肠病如何影响心血管并发症的风险以及药物治疗的作用。方法:使用诸如炎症性肠病、克罗恩病、溃疡性结肠炎、心血管疾病、心包炎、血栓栓塞等关键词在PubMed上进行搜索。对截至2023年3月的相关文献进行了审查和总结,这些文献包括来自各种临床试验、荟萃分析、回顾性/前瞻性队列研究以及现行指南的数据。