4.6 INFLAMMATION AND AORTIC STIFFNESS. A MULTICENTRE LONGITUDINAL STUDY IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Background: Inflammatory Bowel Disease (IBD) is characterized by a low prevalence of traditional risk factors, an increased aortic pulse-wave velocity (aPWV) [1] and an excess of cardiovascular events. We have previously hypothesized that the difference between expected and observed cardiovascular risk could be explained by chronic inflammation [2]. In this multicentre longitudinal study, we tested the hypothesis that increased aPWV is reversible with anti-tumor necrosis factor-alpha (anti-TNFα) therapy. Methods: We enrolled 334 patients (82 patients with ulcerative colitis [UC], 85 patients with Crohn’s disease [CD] and 167 healthy control subjects matched for age, sex and mean blood pressure) from 3 Centres in Europe and followed up them for 4 years (range 2.5–5.7 years). Results: At baseline, IBD patients had higher aPWV than controls. IBD patients in remission and those treated with anti-TNFα during follow-up experienced an aortic destiffening whereas aPWV increased in those with active disease and those treated with salicylates (Figure 1, P = 0.01). Disease duration (P = 0.02) and, in UC patients, the increase in CRP during follow-up (P = 0.02) were associated with aortic stiffening. All these results were confirmed after adjustment for major confounders. Finally, the duration of anti-TNFα therapy was not associated with the magnitude of the reduction in aPWV at the end of follow-up (P = 0.85). This finding could suggest that anti-TNFα therapy has a beneficial effect on functional arterial stiffening. Conclusions: Long-term anti-TNFα therapy reduced aPWV, an established surrogate measure of cardiovascular risk, in patients with IBD. This suggests that effective control of inflammation may reduce cardiovascular risk in these patients.

Abstract licence: CC BY

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