Inflammatory bowel disease and cardiovascular diseases

Bing Chen, Lauren V. Collen, Craig Mowat, Kim L. Isaacs, Siddharth Singh, Sunanda V. Kane, Francis A. Farraye, Scott Snapper, Hani Jneid, Carl J. Lavie, Chayakrit Krittanawong (Lead / Corresponding author)

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Emerging data showed patients with chronic inflammatory disorders, including inflammatory bowel disease, are more likely to develop atherosclerotic cardiovascular diseases, heart failure, and atrial fibrillation. This article aims to review the evidence of those associations. Methods: PubMed was searched from inception to January 2022 using the keywords, including inflammatory bowel diseases, Crohn disease, ulcerative colitis, atherosclerotic cardiovascular disease, coronary artery disease, cardiovascular disease, atrial fibrillation, heart failure, and premature coronary artery disease. Relevant literature, including retrospective/prospective cohort studies, clinical trials, meta-analyses, and guidelines, were reviewed and summarized. Results: Both ulcerative colitis and Crohn disease are associated with an increased risk of atherosclerotic cardiovascular diseases, cerebrovascular accidents, premature coronary artery disease, and atrial fibrillation. Ulcerative colitis is associated with an increased risk of heart failure. The increased atrial fibrillation occurred during inflammatory bowel disease flares and persistent activity but not during periods of remission. Hypotheses for the mechanism underlying the association of inflammatory bowel disease and atherosclerotic cardiovascular diseases include shared risk factors (ie, obesity, diabetes, smoking, diet) and pathophysiology (gut microbiome dysfunction) or adverse effects from inflammatory bowel disease itself or its treatment (ie, chronic inflammation, dyslipidemia, thrombocytosis, steroids). Conclusion: Inflammatory bowel disease is associated with an increased risk of atherosclerotic cardiovascular diseases, heart failure, and atrial fibrillation. A multidisciplinary team with gastroenterologists and cardiologists is needed to optimize the care for patients with inflammatory bowel disease and associated cardiac diseases.

Original languageEnglish
Pages (from-to)1453-1460
Number of pages8
JournalAmerican Journal of Medicine
Volume135
Issue number12
Early online date2 Sep 2022
DOIs
Publication statusPublished - Dec 2022

Keywords

  • Inflammatory bowel disease
  • ulcerative colitis
  • Crohn's disease
  • atherosclerotic cardiovascular disease
  • atrial fibrillation
  • heart failure

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