Cardiovascular involvement in inflammatory bowel disease: Dangerous liaisons

Table 2 Cardiovascular risk and inflammatory bowel disease treatment

Study	Results
Longitudinal study[13] 14 IBD subjects treated only with salicylates, 11 subjects treated with steroids and azathioprine, 7 subjects treated with anti TNF-α, and 30 matched controls pulse wave velocity was measured at baseline and 3.4 ± 0.5 yr later	Carotid-femoral pulse wave velocity increased significantly at follow-up in IBD subjects treated with salicylates, No increase of PWV in patients treated with steroids and azathioprine or anti TNF-α
Nationwide, population-based, cohort study, patients with IBD followed for up to 11 years after exposure to TNF-α antagonists	Protective effect of TNF-α antagonist on IHD
Cohort of 50756 IBD patients of whom 3109 had been exposed to TNF-α antagonists during 1999-2010[14]	TNF-α antagonists use might be a risk factor for CVA (increased trend, none of the values reached statistical significance)
Large retrospective study[15]	18% reduction in initiation of oral steroids
1986 statin exposed and 9871 unexposed subjects with IBD	Statistical significance for atorvastatin only
	Greater reduction in steroid use for UC patients and no reduction in Crohn’s disease
	Reduce hazard of anti TNF-α use, surgery and hospitalization (no statistical significance)

UC: Ulcerative colitis; IBD: Inflammatory bowel disease; CVA: Cerebrovascular accidents; IHD: Ischemic heart disease.