Title:Cardiovascular Complications in Inflammatory Bowel Disease
Volume: 16
Issue: 3
Author(s): Rudolf Schicho, Gunther Marsche and Martin Storr
Affiliation:
Keywords:
Cardiovascular diseases, coronary artery disease, Crohn’s disease, dyslipidemia, endotoxins, LPS, thromboembolism,
ulcerative colitis.
Abstract: Over the past years, a growing number of studies have indicated that patients suffering from
inflammatory bowel disease (IBD) have an increased risk of developing cardiovascular disease. Both
are chronic inflammatory diseases and share certain pathophysiological mechanisms that may influence
each other. High levels of cytokines, C-reactive protein (CRP), and homocysteine in IBD patients
may lead to endothelial dysfunction, an early sign of atherosclerosis. IBD patients, in general, do not
show the typical risk factors for cardiovascular disease but changes in lipid profiles similar to the ones
seen in cardiovascular events have been reported recently. Higher levels of coagulation factors frequently
occur in IBD which may predispose to arterial thromboembolic events. Finally, the gut itself may have an impact
on atherogenesis during IBD through its microbiota. Microbial products are released from the inflamed mucosa into the
circulation through a leaky barrier. The induced rise in proinflammatory cytokines could contribute to endothelial damage,
artherosclerosis and cardiovascular events. Although large retrospective studies favor a link between IBD and cardiovascular
diseases, the mechanisms behind still remain to be determined.