Masson Walter, Fernández-Villar Gonzalo, Martinez-Elhelou Solange
Cardiology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Gastroenterology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Adv Ther. 2025 May;42(5):2118-2134. doi: 10.1007/s12325-025-03154-2. Epub 2025 Mar 27.
Inflammatory bowel disease (IBD) is a complex condition characterized by inflammation of the gastrointestinal system, encompassing Crohn's disease and ulcerative colitis. Patients diagnosed with IBD have an increased risk of atherosclerotic cardiovascular disease. This heightened risk can be attributed to a combination of mechanisms, including traditional risk factors, chronic inflammation, intestinal dysbiosis, increased risk of thrombosis, and the use of certain medications such as corticosteroids. There are significant gaps in current knowledge, particularly regarding the management of risk factors and the use of medications for cardiovascular disease prevention. Similarly, the cardiovascular effects of specific IBD therapies, particularly the newer ones, are not yet fully understood. This review focuses on the epidemiological evidence linking IBD with cardiovascular risk factors and cardiovascular disease. It describes the potential pathophysiological mechanisms underlying this association and examines the challenges involved in accurately assessing cardiovascular risk in these patients, including the utility of complementary tools such as subclinical atherosclerosis detection. Additionally, we consider the potential therapeutic implications for managing these patients. Finally, this review also underscores the importance of multidisciplinary collaboration. Effective teamwork among gastroenterologists, cardiologists, and general practitioners is essential for providing comprehensive care to patients with IBD.
炎症性肠病（IBD）是一种复杂的病症，其特征为胃肠道系统炎症，包括克罗恩病和溃疡性结肠炎。被诊断为IBD的患者患动脉粥样硬化性心血管疾病的风险增加。这种风险升高可归因于多种机制的综合作用，包括传统风险因素、慢性炎症、肠道菌群失调、血栓形成风险增加以及使用某些药物（如皮质类固醇）。目前的知识存在重大空白，特别是在风险因素管理和用于预防心血管疾病的药物使用方面。同样，特定IBD疗法（尤其是较新的疗法）对心血管的影响尚未完全了解。本综述重点关注将IBD与心血管风险因素及心血管疾病联系起来的流行病学证据。它描述了这种关联背后潜在的病理生理机制，并探讨了在准确评估这些患者心血管风险方面所涉及的挑战，包括亚临床动脉粥样硬化检测等辅助工具的实用性。此外，我们还考虑了对这些患者进行管理的潜在治疗意义。最后，本综述还强调了多学科协作的重要性。胃肠病学家、心脏病学家和全科医生之间的有效团队合作对于为IBD患者提供全面护理至关重要。
