Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Nov 26, 2023; 15(11): 553-570
Published online Nov 26, 2023. doi: 10.4330/wjc.v15.i11.553
Cardiovascular implications of inflammatory bowel disease: An updated review
Arshia Bhardwaj, Arshdeep Singh, Vandana Midha, Ajit Sood, Gurpreet Singh Wander, Bishav Mohan, Akash Batta
Arshia Bhardwaj, Arshdeep Singh, Ajit Sood, Department of Gastroenterology, Dayanand Medical College and Hospital, Punjab, Ludhiana 141001, India
Vandana Midha, Department of Internal Medicine, Dayanand Medical College and Hospital, Punjab, Ludhiana 141001, India
Gurpreet Singh Wander, Bishav Mohan, Akash Batta, Department of Cardiology, Dayanand Medical College and Hospital, Punjab, Ludhiana 141001, India
Author contributions: Bhardwaj A writing the article; Singh A writing the article, analysis and interpretation, critical revision of the article; Midha V critical revision of the article, supervision; Sood A critical revision of the article, supervision; Wander GS critical revision of the article, supervision; Mohan B critical revision of the article, supervision; Batta A conception and design, critical revision of the article, final approval of the article.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Akash Batta, Doctor, FACC, MBBS, MD, Assistant Professor, Department of Cardiology, Dayanand Medical College and Hospital, Tagore Nagar, Civil Lines, Punjab, Ludhiana 141001, India. akashbatta02@gmail.com
Received: October 8, 2023
Peer-review started: October 8, 2023
First decision: October 17, 2023
Revised: October 22, 2023
Accepted: November 8, 2023
Article in press: November 8, 2023
Published online: November 26, 2023
Processing time: 45 Days and 15.3 Hours
Abstract

Emerging data highlights the heightened risk of atherosclerotic cardiovascular diseases (ASCVD) in patients with chronic inflammatory disorders, particularly those afflicted with inflammatory bowel disease (IBD). This review delves into the epidemiological connections between IBD and ASCVD, elucidating potential underlying mechanisms. Furthermore, it discusses the impact of current IBD treatments on cardiovascular risk. Additionally, the cardiovascular adverse effects of novel small molecule drugs used in moderate-to-severe IBD are investigated, drawing parallels with observations in patients with rheumatoid arthritis. This article aims to comprehensively evaluate the existing evidence supporting these associations.

To achieve this, we conducted a meticulous search of PubMed, spanning from inception to August 2023, using a carefully selected set of keywords. The search encompassed topics related to IBD, such as Crohn’s disease and ulcerative colitis, as well as ASCVD, including coronary artery disease, cardiovascular disease, atrial fibrillation, heart failure, conduction abnormalities, heart blocks, and premature coronary artery disease. This review encompasses various types of literature, including retrospective and prospective cohort studies, clinical trials, meta-analyses, and relevant guidelines, with the objective of providing a comprehensive overview of this critical intersection of inflammatory bowel disease and cardiovascular health.

Keywords: Inflammatory bowel diseases; Cardiovascular disorders; Pericarditis; myocarditis; Thromboembolism; Chronic inflammation; Oxidative stress; Endothelial dysfunction

Core Tip: A substantial association has been established between cardiovascular disorders (CVD) and inflammatory bowel diseases (IBD), with a notably higher prevalence of CVD in IBD patients compared to the general population. Potential mechanisms underlying CVD in IBD involve chronic inflammation, oxidative stress, altered platelet function, endothelial dysfunction, hypercoagulability, gut dysbiosis, and drug-related side effects. This review comprehensively synthesizes the latest evidence on the epidemiology, pathophysiological mechanisms, and cardiovascular manifestations in IBD.