Opinion Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Aug 12, 2020; 11(5): 104-113
Published online Aug 12, 2020. doi: 10.4291/wjgp.v11.i5.104
Atherosclerotic cardiovascular disease in inflammatory bowel disease: The role of chronic inflammation
Simcha Weissman, Preetika Sinh, Tej I Mehta, Rishi K Thaker, Abraham Derman, Caleb Heiberger, Nabeel Qureshi, Viralkumar Amrutiya, Adam Atoot, Maneesh Dave, James H Tabibian
Simcha Weissman, Nabeel Qureshi, Viralkumar Amrutiya, Adam Atoot, Department of Medicine, Hackensack Meridian Health Palisades Medical Center, North Bergen, NJ 07047, United States
Preetika Sinh, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, Milwaukee, WI 53226, United States
Tej I Mehta, Caleb Heiberger, Department of Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, SD 57108, United States
Rishi K Thaker, Department of Medicine, New York Presbyterian, Brooklyn, NY 11215, United States
Abraham Derman, Department of Medicine, Mount Sinai-Saint Luke’s Roosevelt, NY 10025, United States
Maneesh Dave, Division of Gastroenterology and Hepatology, University of California Davis School of Medicine, Sacramento, CA 95817, United States
James H Tabibian, Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States
James H Tabibian, David Geffen School of Medicine at UCLA, Los Angeles, CA 90001, United States
Author contributions: Weissman S and Sinh P were co-first authors; Weissman S, Mehta TI, Derman A, Qureshi N, Amrutiya V and Thaker RK assisted with manuscript preparation and editing; Heiberger C assisted with creating and obtaining figures; Atoot A, Tabibian JH and Sinh P drafted and critically revised the manuscript; Tabibian JH, Dave M and Sinh P provided supervision; Weissman S is the article guarantor; all authors agree to the submission of this manuscript.
Conflict-of-interest statement: The authors declare no conflict of interests.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Preetika Sinh, MD, Assistant Professor, Division of Gastroenterology and Hepatology, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI 53226, United States. psinh@mcw.edu
Received: January 17, 2020
Peer-review started: January 17, 2020
First decision: April 9, 2020
Revised: April 24, 2020
Accepted: June 27, 2020
Article in press: June 27, 2020
Published online: August 12, 2020
Processing time: 199 Days and 9.7 Hours
Abstract

Inflammatory bowel disease (IBD) causes systemic vascular inflammation. The increased risk of venous as well as arterial thromboembolic phenomena in IBD is well established. More recently, a relationship between IBD and atherosclerotic cardiovascular disease (ASCVD) has been postulated. Systemic inflammatory diseases, such as rheumatoid arthritis and systemic lupus erythematosus, have well characterized cardiac pathologies and treatments that focus on prevention of disease associated ASCVD. The impact of chronic inflammation on ASCVD in IBD remains poorly characterized. This manuscript aims to review and summarize the current literature pertaining to IBD and ASCVD with respect to its pathophysiology and impact of medications in order to encourage further research that can improve understanding and help develop clinical recommendations for prevention and management of ASCVD in patients with IBD.

Keywords: Crohn’s disease; Ulcerative colitis; Atherosclerosis; Thromboembolism; Chronic inflammation; Pathophysiology

Core tip: Chronic inflammation in patients with inflammatory bowel disease (IBD) leads to increased risk of atherosclerotic cardiovascular disease (ASCVD). However, the role and potential impact of IBD therapy in modifying ASCVD risk, and vice-versa, remains poorly understood. Herein, we highlight the importance of ASCVD as an extraintestinal manifestation of IBD, discuss the pathophysiology common to both diseases, and explore the role of non-traditional risk factors of ASCVD in IBD. We intend to identify avenues for further clinical and translational research that may help develop clinical recommendations for the management of ASCVD risk in patients with IBD.