Inflammatory bowel disease and cardiovascular complications

Introduction: Inflammatory bowel diseases refer to a group of chronic inflammatory diseases that target ma-inly the gastrointestinal tract and it is thought to appear in genetically predisposed individuals. Inflammatory bowel disease has appears in two main forms: Crohn’s disease and ulcerative colitis.
Purpose: The aim of this review is to give an update on the existing literature on the association between inflammatory bowel disease and risk of cardiovascular disease.
Methods: A systematic literature search for cardiovas-cular risk in inflammatory bowel disease was perfor-med using PubMed, Scopus, Web of Science, and Go-ogle Scholar databases.
Results: IBD is associated with a wide range of extrain-testinal manifestations: hepatobiliary, genito-urinary (fistulization, obstructive uropathy, nephrolithiasis), musculoskeletal (arthopathy, osteoporosis, osteone-crosis, osteomyelitis or abcess, hypertrophic osteoart-hropathy), respiratory (bronchiectasis, chronic bron-chitis), ophthalmologic (episcleritis, anterior uveitis), cutaneous (pyoderma gangrenosum, erythema nodo-sum) and cardiovascular. The arterial thromboembolic complications have also a higher incidence among IBD patients (ischemic heart disease – 1.2 fold, cerebrovas-cular events – 1.2 fold, mesenteric ischemia-3.5 fold). The arterial thromboembolic complications occur less frequently than the venous ones. Venous thromboem-bolism can be triggered by genetic or acquired factors. The most frequent prothrombotic acquired factors include: hospitalization, surgical procedures, central venous catheters, prolonged immobilization, glucocor-ticosteroids therapy, cigarette smoking, vitamin defi-ciencies, dehydration, hormonal replacement therapy. Myocarditis and pericarditis are a rare extra-intesti-nal manifestation of both ulcerative colitis and Crohn’ disease and can be idhiopatic or arise in response to numerous systemic insults. Cardiac amyloidosis is a manifestation of one of several systemic amyloidoses. Disease affects multiple organs and tissues with ex-tracellular deposition of pathologic, insoluble fibrillar proteins.
Conclusions: Cardiovascular manifestations include: thromboembolic complications (arterial and venous), myocarditis, pericarditis and cardiac amyloidosis.The thromboembolic complications can be divided in two categories: arterial and venous. IBD patients have a 1.7-5.9 fold higher risk of developing venous thromboem-bolism. The risk is higher at the patients with ulcerative colitis.

ISSN – online: 2734 – 6382
ISSN-L 1220-658X
ISSN – print: 1220-658X
The Romanian Journal of Cardiology is indexed by:
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CODE: 379
CME Credits: 10 (Romanian College of Physicians)