Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Clinical and Experimental Medicine
Published in: Clinical and Experimental Medicine 4/2020

Open Access 01-11-2020 | Ulcerative Colitis | Review Article

The risk of cardiovascular complications in inflammatory bowel disease

Authors: Piotr Czubkowski, Marcin Osiecki, Edyta Szymańska, Jarosław Kierkuś

Published in: Clinical and Experimental Medicine | Issue 4/2020

Login to get access

Abstract

Inflammatory bowel disease (IBD) is a chronic, relapsing disease of unknown etiology involving gastrointestinal tract. IBD comprises two main entities: ulcerative colitis and Crohn’s disease. Several studies showed increased risk of cardiovascular complications in chronic inflammatory disorders, especially during IBD relapses. Endothelium plays a role in physiologic regulation of vascular tone, cell adhesion, migration and resistance to thrombosis. Also, its dysfunction is associated with increased risk of atherosclerosis development. There are several potential links between chronic IBD-related inflammatory processes and the risk of cardiovascular disease, but insight into pathogenetic pathways remains unclear. We present the current concepts and review of adult and pediatric studies on the risk of CVD in IBD.
Literature
1.
Timmis A, Townsend N, Gale CP, et al. European Society of Cardiology: Cardiovascular disease statistics 2019. Eur Heart J. 2020;41:12–85.PubMed
2.
Sykora J, Pomahavá R, Kreslová M, Cvalínová D, Štych P, Schwarz J. Current global trends in the incidence of pediatric-onset inflammatory bowel disease. World J Gastroenterol. 2018;24(25):2741–63.PubMedPubMedCentral
3.
Yarur AJ, Deshpande AR, Pechman DM, et al. Inflammatory bowel disease is associated with an increased incidence of cardiovascular events. Am J Gastroenterol. 2011;106:741–7.PubMed
4.
Kristensen SL, Ahlehoff O, Lindhardsen J, Erichsen R, Jensen GV, Torp-Pedersen C, et al. Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death: a Danish nationwide cohort study. PLoS ONE. 2013;8:e56944.PubMedPubMedCentral
5.
Ng SC, Shi HY, Hamidi N, et al. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. Lancet. 2018;390(10114):2769–78.
6.
Townsend N, Wilson L, Bhatnagar P, et al. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016;37(42):3232–45.PubMed
7.
Mäki-Petäjä KM, Hall FC, Booth AD, Wallace SML, Yasmin Bearcroft PWP, Harish S, et al. Rheumatoid arthritis is associated with increased aortic pulse-wave velocity, which is reduced by anti-tumor necrosis factor-alpha therapy. Circulation. 2006;114(11):1185–92.PubMed
8.
Roman MJ, Devereux RB, Schwartz JE, et al. Arterial stiffness in chronic inflammatory diseases. Hypertension. 2005;46(1):194–9.PubMed
9.
Baena-Díez JM, Garcia-Gil M, Comas-Cufí M, et al. Association between chronic immune-mediated inflammatory diseases and cardiovascular risk. Heart. 2018;104(2):119–26.PubMed
10.
Zanoli L, Rastelli S, Inserra G, Castellino P. Arterial structure and function in inflammatory bowel disease. World J Gastroenterol. 2015;21:11304–11.PubMedPubMedCentral
11.
12.
Pepe M, Cecere A, D’Alessandro P, Fumarola F, Ciccone MM, Marchese A, et al. Massive stent thrombosis during active ulcerative colitis: the tricky balance between manifest hemorrhagic and concealed thrombotic risk. Clin Exp Med. 2018;18(4):481–5.PubMed
13.
Sun HH, Tian F. Inflammatory bowel disease and cardiovascular disease incidence and mortality: a meta-analysis. J Prev Cardiol. 2018;25(15):1623–31.
14.
Tine JA, Camilla J, Kobylecki J. Cardiovascular risk profile among patients with inflammatory bowel disease: a population-based study of more than 100 000 individuals. JCC. 2019;13(3):319–23.
15.
Tang WH, Kitai T, Hazen SL. Gut microbiota in cardiovascular health and disease. IRC Res. 2017;120(7):1183–96.
16.
Abraham C, Cho JH. Inflammatory bowel disease. Engl J Med. 2009;361(21):2066–78.
17.
Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;352(16):1685–95.PubMed
18.
Buongusto F, Bernardazzi C, Yoshimoto AN, Nanini HF, Coutinho RL, Carneiro AJV, et al. Disruption of the Hedgehog signaling pathway in inflammatory bowel disease fosters chronic intestinal inflammation. Clin Exp Med. 2017;17(3):351–69.PubMed
19.
van de Wouw J, Sorop O, van Drie RWA, et al. Perturbations in myocardial perfusion and oxygen balance in swine with multiple risk factors: a novel model of ischemia and no obstructive coronary artery disease. Basic Res Cardiol. 2020;115(2):21.PubMedPubMedCentral
20.
Binion DG, West GA, Ina K, et al. Enhanced leukocyte binding by intestinal microvascular endothelial cells in inflammatory bowel disease. Gastroenterology. 1997;112(6):1895–907.PubMed
21.
Danesh J, Kaptoge S, Mann AG, et al. Long-term interleukin-6 levels and subsequent risk of coronary heart disease: two new prospective studies and a systematic review. PLoS Med. 2008;5:e78.PubMedPubMedCentral
22.
Danese S, Sgambato A, Papa A, et al. Homocysteine triggers mucosal microvascular activation in inflammatory bowel disease. Am J Gastroenterol. 2005;100(4):886–95.PubMed
23.
Emerging Risk Factors Collaboration, Kaptoge S, Angelantonio ED, Lowe G, Pepys MB, Thompson SG, Collins R, Danesh J. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010;375(9709):132–40.
24.
Garolla A, D’Incà R, Checchin D, et al. Reduced endothelial progenitor cell number and function in inflammatory bowel disease: a possible link to the pathogenesis. Am J Gastroenterol. 2007;104(10):2500–7.
25.
Briskin M, Winsor-Hines D, Shyjan A, et al. Human mucosal addressin cell adhesion molecule-1 is preferentially expressed in intestinal tract and associated lymphoid tissue. Am J Pathol. 1997;151(1):97–110.PubMedPubMedCentral
26.
Furchgott RF, Zawadzki JV. The obligatory role of endothelial cells in the relaxation of arterial smooth muscle by acetylcholine. Nature. 1980;288:373–6.PubMed
27.
Horowitz S, Binion DG, Nelson VM, et al. Increased arginase activity and endothelial dysfunction in human inflammatory bowel disease. Am J Physiol Gastrointest Liver Physiol. 2007;292(5):1323–36 et al. Asymmetrical dimethylarginine independently predicts total and cardiovascular mortality in individuals with angiographic coronary artery disease (the Ludwigshafen Risk and Cardiovascular Health study).Clin Chem. 2007;53(2):273–283.
28.
Edfeldt K, Swedenborg J, Hansson GK, Yan ZQ. Expression of toll-like receptors in human atherosclerotic lesions: a possible pathway for plaque activation. Circulation. 2002;105:1158–61.PubMed
29.
Owczarek D, Cibor D, Mach T. Asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), arginine, and 8-iso-prostaglandin F2alpha (8-iso-PGF2alpha) level in patients with inflammatory bowel diseases. Inflamm Bowel Dis. 2010;6(1):52–7.
30.
Danese S, Scaldaferri F, Vetrano S, et al. Critical role of the CD40–CD40-ligand pathway in regulating mucosal inflammation-driven angiogenesis in inflammatory bowel disease. Gut. 2007;56(9):1248–56.PubMedPubMedCentral
31.
Fishbein MC, Fishbein GA. Arteriosclerosis: facts and fancy. Cardiovasc Pathol. 2015;24(6):335–42.PubMed
32.
Nevulis MG, Baker C, Lebovics E, et al. Overview of link between inflammatory bowel disease and cardiovascular disease. Cardiol Rev. 2018;26(6):287–93.PubMed
33.
Alkim H, Koksal AR, Boga B, et al. Etiopathogenesis, prevention, and treatment of thromboembolism in inflammatory bowel disease. Clin Appl Thromb Hemost. 2017;23(6):501–10.PubMed
34.
35.
McDonnel M, Liang Y, Noronha A, et al. Systemic toll-like receptor ligands modify B-cell responses in human inflammatory… and more dramatically increases on B cells from CD patients. Inflammatory Bowel Dis. 2010;17(1):298–307.
36.
Rungoe CH, Andersen NN, Jess T. Inflammatory bowel disease and risk of coronary heart disease. Trends Cardiovasc Med. 2015;25(8):699–704.PubMed
37.
Zanoli L, Rastelli S, Granata A, Inserra G, Empana JP, Boutouyrie P, Laurent S, Castellino PJ. Arterial stiffness in inflammatory bowel disease: a systematic review and meta-analysis. Hypertension. 2016;34(5):822–9.
38.
39.
Zanoli L, Boutouyrie P, Fatuzzo P, et al. Inflammation and aortic stiffness: an individual participant data meta-analysis in patients with inflammatory bowel disease. J Am Heart Assoc. 2017;6(10):e007003.PubMedPubMedCentral
40.
Mäki-Petäjä KM, Hall FC, Booth AD, Wallace SML, Bearcroft PW, et al. Rheumatoid arthritis is associated with increased aortic pulsewave velocity, which is reduced by antitumor necrosis factor-alpha therapy. Circulation. 2006;114:1185–92.PubMed
41.
Angel K, Provan SA, Fagerhol MK, et al. Effect of 1-year anti-TNF-a therapy on aortic stiffness, carotid atherosclerosis, and Calprotectin in inflammatory arthropathies: a controlled study. Am J Hypertens. 2012;25(6):644–50.PubMedPubMedCentral
42.
Bernstein CN, Benchimol EI, Bitton A, et al. The impact of inflammatory bowel disease in Canada 2018: extra-intestinal diseases in IBD. J Can Assoc Gastroenterol. 2019;2(Suppl 1):73–80.
43.
Nguyen GC, Bernstein CN, Bitton A, et al. Consensus statements on the risk, prevention, and treatment of venous thromboembolism in inflammatory bowel disease: Canadian Association of Gastroenterology. Gastroenterology. 2014;146(3):835–48.PubMed
44.
Schicho R, Marsche G, Storr M. Cardiovascular complications in inflammatory bowel disease. Curr Drug Targets. 2015;16(3):181–8.PubMedPubMedCentral
45.
Kirsner J, Shorter R. Inflammatory bowel disease. Baltimore: Williams & Wilkins; 1995.
46.
Wakefield AJ, Sawyerr AM, Dhillon AP, et al. Pathogenesis of Crohn’s disease: multifocal gastrointestinal infarction. Lancet. 1989;2:1057–62.PubMed
47.
Feng W, Chen G, Cai D, et al. Inflammatory bowel disease and risk of ischemic heart disease: an updated meta-analysis of cohort studies. J Am Heart Assoc. 2017;6(8):e005892.PubMedPubMedCentral
48.
Kirchgesner J, Beaugerie L, Carrat F, Andersen NN, Jess T, Schwarzinger M. Increased risk of acute arterial events in young patients and severely active IBD: a nationwide French cohort study. Gut. 2018;67(7):1261–8.PubMed
49.
Fumery M, Xiaocang C, Dauchet L, et al. Thromboembolic events and cardiovascular mortality in inflammatory bowel diseases: a meta-analysis of observational studies. J Crohns Colitis. 2014;8(6):469–79.PubMed
50.
Kappelman MD, Horvath-Puho E, Sandler RS, et al. Thromboembolic risk among Danish children and adults with inflammatory bowel diseases: a population-based nationwide study. Gut. 2011;60(7):937–43.PubMed
51.
Bernstein CN, Blanchard JF, Houston DS. The incidence of deep venous thrombosis and pulmonary embolism among patients with inflammatory bowel disease: a population-based cohort study. Thromb Haemost. 2001;85(3):430–4.PubMed
52.
Bernstein CN, Wajda A, Blanchard JF. The incidence of arterial thromboembolic diseases in inflammatory bowel disease: a population-based study. Clin Gastroenterol Hepatol. 2008;6(1):41–5.PubMed
53.
Singh S, Singh H, Loftus EV, et al. Risk of cerebrovascular accidents and ischemic heart disease in patients with inflammatory bowel disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014;12(3):382–93.PubMed
54.
Willeit P, Thompson SG, Agewall S, et al. PROG-IMT Group. Inflammatory markers and extent and progression of early atherosclerosis: meta-analysis of individual-participant-data from 20 prospective studies of the PROG-IMT collaboration. Prev Cardiol. 2016;23(2):194–205.
55.
Sager HB, Koenig W, et al. Acute inflammation and long-term cardiovascular risk: identifying an unrecognised vulnerable gap. J Prev Cardiol. 2017;24(18):1956–7.
56.
Grainge MJ, West J, Card TR. Venous thromboembolism during active disease and remission in inflammatory bowel disease: a cohort study. Lancet. 2010;375:657–63.PubMed
57.
Sam JJ, Bernstein CN, Razik R, Thanabalan R, Ngugen GC, et al. Physicians’ perceptions of risks and practices in venous thromboembolism prophylaxis in inflammatory bowel disease. Dig Dis Sci. 2013;58:46–52.PubMed
58.
Lurz E, Aeschbacher E, Carman N, et al. Pulse wave velocity measurement as a marker of arterial stiffness in pediatric inflammatory bowel disease: a pilot study. Eur J Pediatr. 2017;176(7):983–7.PubMed
59.
Aloi M, Tromba L, Di Nardo G, et al. Premature subclinical atherosclerosis in pediatric inflammatory bowel disease. J Pediatr. 2012;161(4):589–94.PubMed
60.
Aloi M, Tromba L, Rizzo V, D’Arcangelo G, et al. Aortic intima-media thickness as an early marker of atherosclerosis in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2015;61(1):41–6.PubMed
61.
Trzeciak-Jedrzejczyk A, Makosiej R, Kolejwa M. The role of adhesion molecules in inflammatory bowel disease in children. Assessment of the possible risk of cardiovascular complications. Gastroenterol Rev. 2017;12(3):181–5.
62.
Winderman R, Rabinowitz SS, Vaidy K, Schwarz SM. Measurement of microvascular function in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2019;68(5):662–8.PubMed
63.
Pac-Kożuchowska E, Krawiec P, Mroczkowska-Juchkiewic A, Pawłowska-Kamieniak A, Kominek K. Inflammatory and lipid-associated markers of cardiovascular diseases in children with first exacerbation of inflammatory bowel disease. Med Sci Monit. 2016;22:1534–9.PubMedPubMedCentral
64.
McKie K, McLoughlin RJ, Hirsh MP, Cleary MA, Aidlen JT. Risk Factors for Venous Thromboembolism in Children and Young Adults With Inflammatory Bowel Disease. J Surg Res 2019. PMID 31181463.
65.
Nylund CM, Goudie A, Garza JM, Crouch G, Denson LA, et al. Venous thrombotic events in hospitalized children and adolescents with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2013;56(5):485–91.PubMed
66.
Voutilainen M, Hutri-Kähönen N, Tossavainen P, et al. Low childhood high density lipoprotein cholesterol levels and subsequent risk for chronic inflammatory bowel disease. Dig Liver Dis. 2018;50(4):348–52.PubMed
67.
McCully K. Homocysteine and the pathogenesis of atherosclerosis. Expert Rev Clin Pharmacol. 2015;8(2):211–9.PubMed
68.
Lai WK, Kan MY. Homocysteine-induced endothelial dysfunction. Ann Nutr Metab. 2015;67(1):1–12.PubMed
69.
Nakano E, Taylor CJ, Chada L, McGaw J, et al. Hyperhomocystinemia in children with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2003;37(5):586–90.PubMed
70.
Lazzerini M, Bramuzzo M, Maschio M, Martelossi S, Ventura A. Thromboembolism in pediatric inflammatory bowel disease: systematic review. Inflamm Bowel Dis. 2011;17(10):2174–83.PubMed
71.
Zitomersky NL, Levin AE, Atkinson BJ, Harney KM, Verhave M, Bousvaros A. Risk factors, morbidity, and treatment of thrombosis in children and young adults with active inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2013;57(3):343–7.PubMed
72.
Bigeh A, Sanchez A, Maestas C, Gulati M. Inflammatory bowel disease and the risk for cardiovascular disease: does all inflammation lead to heart disease? Trends Cardiovasc Med. 2019;1050–1738(19):30139–42.
73.
Barclay AR, Keightley JM, Horrocks I, et al. Cerebral thromboembolic events in pediatric patients with inflammatory bowel disease. Inflamm Bowel Dis. 2010;16(4):677–83.PubMed
74.
75.
Otto CM. Heartbeat: chronic inflammatory disorders and cardiovascular disease. Heart. 2016;102(24):1935–6.PubMed
Metadata
Title
The risk of cardiovascular complications in inflammatory bowel disease
Authors
Piotr Czubkowski
Marcin Osiecki
Edyta Szymańska
Jarosław Kierkuś
Publication date
01-11-2020
Publisher
Springer International Publishing
Published in
Clinical and Experimental Medicine / Issue 4/2020
Print ISSN: 1591-8890
Electronic ISSN: 1591-9528
DOI
https://doi.org/10.1007/s10238-020-00639-y

Other articles of this Issue 4/2020

Clinical and Experimental Medicine 4/2020 Go to the issue

Original Article

Development and validation of a metabolic gene signature for predicting overall survival in patients with colon cancer

Review Article

Organ-specific manifestations of COVID-19 infection

Original Article

Expression of BAFF and BAFF receptors in primary Sjögren’s syndrome patients with ectopic germinal center-like structures

Original Article

Imaging characteristics and prognostic values of hepatic epithelioid hemangioendothelioma on 18F-FDG PET/CT

Original Article

IGFBP3 as an indicator of lymph node metastasis and unfavorable prognosis for papillary thyroid carcinoma

Original Article

The effects of apoptosis and apelin on lymph node metastasis in invasive breast carcinomas

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits