Inflammatory bowel disease and cardiovascular disease incidence and mortality: A meta-analysis

Abstract

Background: The risk of cardiovascular disease occurrence and death in inflammatory bowel disease patients is still unclear. Design: Meta-analysis. Methods: Pertinent studies were identified by searching articles in PubMed and Web of Knowledge to December 2017 and reviewing the reference lists of the retrieved articles. We used the fixed-effect model to pool the study-specific estimates when there was no indication of heterogeneity; otherwise, the random-effect model was used. Results: A total of 27 articles was included, of which 11 studies reported the risk of cardiovascular disease incidence and 16 studies reported the risk of cardiovascular disease death. The pooled relative risks were 1.25 (95% confidence interval (CI): 1.08, 1.44), 1.17 (95% CI: 1.07, 1.27) and 1.12 (95% CI: 1.05, 1.21) for cerebrovascular disease, coronary heart disease and myocardial infarction, respectively. In particular, the pooled relative risk was much higher in females. The pooled standardized mortality ratios were 1.01 (95% CI: 0.90, 1.14) for Crohn's disease patients and 0.93 (95% CI: 0.86, 1.01) for ulcerative colitis patients with low heterogeneity across studies. No publication bias was detected. Conclusions: There was a positive association between inflammatory bowel disease and higher risk of cardiovascular disease incidence, particularly in females. Such an association was not observed for cardiovascular disease mortality.

Cardiovascular Manifestations of Inflammatory Bowel Disease: Pathogenesis, Diagnosis, and Preventive Strategies

“…They found a significantly increased risk for mesenteric ischemia (adjusted odds ratio 3.4; 95% CI, 2.9-4.0), venous thromboembolism (adjusted odds ratio, 1.38; 95% CI, 1.25-1.53), and arrhythmias (among young females, adjusted odds ratio, 2.05; 95% CI, 1.72-2.44), but not with any other cardiovascular conditions (such as stroke or acute coronary syndrome) [93]. But cardiovascular mortality is not increased in IBD patients when compared to the general population, with no differences between UC and CD [138].…”

Mortality After First Hospital Admission for Inflammatory Bowel Disease: A Nationwide Registry Linkage Study

“…Although inflammatory disorders are frequently linked with cardiovascular disease, 38 some studies have indeed suggested that IBD does not appear to be a risk factor for cardiovascular disease mortality. 39, 40 Interestingly, lower respiratory tract infections were also less often found to be the cause of death in CD and UC patients than in individuals from the general population. With the introduction of new, powerful drugs, the prevalence of serious infections could be expected to rise.…”

The risk of cardiovascular complications in inflammatory bowel disease

“…The prevalence of venous thromboembolism (VTE) varies between 1 and 7% among patients with IBD. This is at least 3 times higher than that in the general population, and the absolute risk significantly increases during hospitalization, active disease and surgery [ 13 ].…”