4.6 Inflammation and Aortic Stiffness. A Multicentre Longitudinal Study in Patients with Inflammatory Bowel Disease

• Published in: Artery research Vol. 24; no. 1; p. 77
• Main Authors: Zanoli, Luca, Ozturk, Kadir, Cappello, Maria
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-12-2018; Springer Nature B.V; BMC
• Subjects: ARTERY 18; Guimaraes Oral Presentation abstracts; Inflammation; Inflammatory bowel disease; Longitudinal studies
• ISSN: 1872-9312; 1876-4401; 1876-4401
• DOI: 10.1016/j.artres.2018.10.045

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 multi-centre 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.