The correlation between heart failure and the risk of ischemic colitis: a systematic review and meta-analysis

Abstract

Background Ischemic colitis is a relatively common gastrointestinal disease caused by hypoperfusion of the colon. Recently, studies have suggested an association between heart failure (HF) and ischemic colitis, even though the magnitude of the reported association varied considerably across the studies. This systematic review and meta-analysis were performed to comprehensively explore whether patients with HF are at a higher risk of ischemic colitis compared with individuals without HF by combining the results of all available observational studies. Methods Systematic literature review was performed using EMBASE, MEDLINE and Google Scholar database up to May 2020. Eligible studies could be any observational ones that evaluated whether patients with HF have a higher risk of ischemic colitis than individuals without HF. Point estimates and standard errors from each eligible study were combined together using the generic inverse variance method of DerSimonian and Laird. Results The systematic review identified 7 case-control studies and 1 cross-sectional study. The pooled analysis found that patients with HF had a significantly higher risk of ischemic colitis with the pooled odds ratio of 3.42 (95% confidence interval 1.49-7.82; I 2 96%). Funnel plot was relatively symmetric and was not suggestive of presence of publication bias. Conclusion A significantly increased risk of ischemic colitis among patients with HF was demonstrated in this systematic review and meta-analysis.

Sheng-Xue-Xiao-Ban Capsule-induced ischemic colitis and pulmonary embolism in an idiopathic thrombocytopenic purpura patient: a rare case report

“…Ischemic colitis is generated by reduced blood flow to the colon, which makes it difficult to maintain cell metabolism, which in turn leads to the acidosis, dysfunction, loss of integrity, and even the death of colon cells (7,8). Trauma to the mesenteric artery, vascular thrombosis or embolism, and surgical error ligation of the inferior mesenteric artery can lead to ischemic colitis, as can heart disease, hypertension, diabetes, and drugs that affect visceral blood flow (9)(10)(11). A previous study examined ischemic colonic mucosal injury related to natural indigo in 8 psoriasis patients who took a natural indigo compound and 5 ITP patients who took SXXBC; 5 of the patients experienced a blurred or disappeared vascular network, 7 had scattered erythema and superficial erosion of mucous membrane, and 6 had scattered superficial ulcers with longitudinal and clear boundaries (12).…”

Congestive Heart Failure Is Associated With Worse Outcomes in Patients With Ischemic Colitis: A Nationwide Study

“…Additionally, most of the other comorbidities included in the analysis, some of which are known risk factors for the development of IC, were associated with worse outcomes when combined with IC. This may reflect a reduced colonic vascular reserve in response to the hemodynamic derangements caused by CHF [8]. Outcomes are also worse with CHF in other vascular pathologies where perfusion is impaired, such as peripheral artery disease [9,10].…”