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Inflammatory bowel disease and associated cardiovascular disease outcomes: A systematic review

Jaiswal V 1 , Batra N 2 , Dagar M 3 , Butey S 4 , Huang H 5 , Chia JE 6 Show all authors , Naz S 7 , Endurance EO 8 , Raj N 9 , Patel S 10 , Maroo D 11 , Ang SP 12 , Hanif M 13 , Mukherjee D 14 , Sarfraz Z 15 , Shrestha AB 16 , Song D 17

Affiliations 

  • 1 Larkin Community Hospital, South Miami, FL
  • 2 Department of Internal Medicine, Beaumont Hospital, Royal Oak, MI
  • 3 Department of Medicine, Himalayan Institute of Medical Science, Dehradun, India
  • 4 Department of Medicine, Indira Gandhi Government Medical College, Nagpur, India
  • 5 Royal College of Surgeons in Ireland, University of Medicine and Health Science, Dublin, Ireland
  • 6 Department of Medicine, International Medical University, Kuala Lumpur, Malaysia
  • 7 Department of Gastroenterology, MD Anderson Cancer Center, Houston, TX
  • 8 Internal Medicine Department, St. Luke's Hospital, St. Louis, MO
  • 9 Department of Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
  • 10 Department of Medicine, GMERS Medical College, Gandhinagar, India
  • 11 Department of Medicine, Maulana Azad Medical College, New Delhi, India
  • 12 Division of Internal Medicine, Rutgers Health/Community Medical Center, Toms River, NJ
  • 13 Suny Upstate Medical University, Syracuse, NY
  • 14 Department of Medicine, Raiganj Government Medical College and Hospital, Raiganj, India
  • 15 Research and Publication, Fatima Jinnah Medical University, Lahore, Pakistan
  • 16 M Abdur Rahim Medical College, Dinajpur, Bangladesh
  • 17 Department of Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
Medicine (Baltimore), 2023 Feb 10;102(6):e32775.
PMID: 36820570 DOI: 10.1097/MD.0000000000032775

Abstract

BACKGROUND: There is limited and conflicting data available regarding the cardiovascular disease outcomes associated with inflammatory bowel disease (IBD).

OBJECTIVE: We aim to perform a systematic review to evaluate the cardiovascular outcomes and mortality associated with IBD patients.

METHODS: A systematic literature search has been performed on PubMed, Embase, Cochrane, and Scopus from inception till May 2022 without any language restrictions.

RESULTS: A total of 2,029,941 patients were included in the analysis from 16 studies. The mean age of the patients was 45.6 years. More females were found compared with males (57% vs 43%). The most common risk factors for cardiovascular disease (CVD) included smoking (24.19%) and alcohol (4.60%). The most common comorbidities includes hypertension (30%), diabetes mellitus (14.41%), dyslipidemia (18.42%), previous CVD (22%), and renal disease (10%). Among outcomes, all-cause mortality among IBD patients was 1.66%; ulcerative colitis (UC): 15.92%; and Crohn disease (CD): 0.30%. Myocardial Infarction (MI) among IBD patients were 1.47%, UC: 30.96%; and CD: 34.14%. CVD events among IBD patients were 1.95%. Heart failure events among IBD patients were 5.49%, stroke events among IBD patients were 0.95%, UC: 2.63%, and CD: 2.41%, respectively.

CONCLUSION: IBD patients are at higher risk for adverse cardiovascular outcomes, especially in women. Although there remains a lack of concrete treatment algorithms and assessment parameters that better characterize IBD risk factors, nutritional modifications and physical activity should be at the forefront of CVD prevention in IBD.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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