Inflammatory Bowel Diseases Clinical Trial
Official title:
Predictors of Subclinical Atherosclerotic Cardiovascular Diseases (ASCVD) in Patients With Inflammatory Bowel Disease
Heart disease and failure are the major causes of mortality and morbidity worldwide, despite significant advances in medical technologies in the diagnosis and treatment of the disease. Cardiovascular disease may arise for various reasons including the steadily increasing incidence of obesity, type 2 diabetes, genetic, environmental, dietary and lifestyle factors. Besides all these, there is much evidence suggetsing that inflammation is an important player in the pathogenesis of heart disease, as well as atherogenesis and atherosclerosis.
Heart disease and failure are the major causes of mortality and morbidity worldwide, despite
significant advances in medical technologies in the diagnosis and treatment of the disease.
Cardiovascular disease may arise for various reasons including the steadily increasing
incidence of obesity, type 2 diabetes, genetic, environmental, dietary and lifestyle factors.
Besides all these, there is much evidence suggetsing that inflammation is an important player
in the pathogenesis of heart disease, as well as atherogenesis and atherosclerosis(1,2).
Clinically, patients with rheumatologic diseases have been found to suffer from coronary
heart disease; thus, regular monitoring for Cardiovascular disease should be included as a
routine assessment for patients with rheumatologic diseases (3). A most common systemic
inflammatory disease is inflammatory bowel disease , which is a collection of ulcerative
colitis and Crohn's disease, a chronic intestinal disease that may arise due to different
factors, and is precipitated by environmental and genetic susceptibility (4,5). Ulcerative
colitis and Crohn's disease are characterized by chronic intestinal inflammation, with
gastrointestinal symptoms including diarrhea, blood and pus in stools, abdominal pain, fever
and weight loss. The incidence of inflammatory bowel disease is on the increase in Canada
(6), Europe (7) and Asia (8
). In ulcerative colitis, inflammation is mostly limited to mucosal layer of the colon and
involves rectum and other parts of colon (9). On the other hand, Crohn's disease shows
characteristic transmural inflammation and fibrosis and occurs as patchy lesions throughout
the gastrointestinal tract (10).
Although inflammatory bowel disease is associated with venous vascular problems such as deep
venous thrombosis (11), the extent of risk for the patients with inflammatory bowel disease
to develop Cardiovascular disease, in particular coronary artery disease is not well
understood. inflammatory bowel disease patients have a 2 to 3-fold higher risk of venous
thromboembolism than the general population (12), and this risk is high during acute disease
flare, as active inflammation tilts the balance between pro-coagulants and anticoagulants,
which leads to the characteristic hypofibrinolysis seen in inflammatory bowel disease (13)
;
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