Early Atherosclerosis and Acute Vascular Events in Ulcerative Colitis Patients – a Case Series
Introduction: In inflammatory bowel disease uncontrolled inflammation may play a role in the early progression of systemic atheromatosis with increased cardiovascular risk. Endothelial dysfunction is mediated by pro-inflammatory cytokines but also by an increased level of CRP which is involved in th...
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Bucharest College of Physicians
2022-06-01
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| author | Ana Maria NEGREANU Ana STEMATE Teodora SPATARU Lucian NEGREANU |
| author_facet | Ana Maria NEGREANU Ana STEMATE Teodora SPATARU Lucian NEGREANU |
| author_sort | Ana Maria NEGREANU |
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| description | Introduction: In inflammatory bowel disease uncontrolled inflammation may play a role in the early progression of systemic atheromatosis with increased cardiovascular risk. Endothelial dysfunction is mediated by pro-inflammatory cytokines but also by an increased level of CRP which is involved in the expression of adhesion molecules and atheroma plaque rupture. Tailored treatment with better control of the ulcerative colitis and endoscopic healing might result in decrease risk of atherothrombotic events. Aim: We decided to use a well-established method (vascular Doppler ultrasound with media-intimate index measurement) to detect an increased incidence of endothelial lesions as predictors of early atheromatosis in patients with ulcerative colitis treated with biological or conventional therapy. Material and methods: We prospectively analyzed 25 patients with RCUH with a mean age of 40 years, 16 with biological treatment. The Student t test, the Mann Whitney U test and the ANOVA test were used to compare continuous variables. Results: A discriminant analysis was performed with the presence of atheroma plaque as a dependent variable and several predictor variables, such as age, triglycerides, cholesterol of patients with ulcerative colitis. Univariate ANOVA analyzes revealed that the presence or absence of atheroma plaque differs in the variables predicting the age, INR and ecoIMT of patients with ulcerative colitis (in the age of patients (F = 8.511, degrees of freedom = 11, p = 0.014) Patients ‚INR (F = 50,437, degrees of freedom = 11, p = 0.001) and Patients’ ecoIMT (F = 7,398, degrees of freedom = 11, p = 0.020) In another analysis of discriminatory function s -introduced the predictor variables specific to measuring the evolution of ulcerative colitis, respectively Mayo and Mayo E (age (F = 0.8511, degrees of freedom = 11, p = 0.014), INR (F = 50.437, degrees of freedom = 11, p = 0.001), ecoIMT (F = 7.398, df = 11, p = 0.020) and Mayo (F = 14.885, degrees of freedom = 11, p = 0.003). Conclusions: Age, endoscopic activity, and INR were correlated with predictive ultrasound changes for atheromatosis. Strengths are the prospective nature of the study and weaknesses are the limited number of patients and the fact that most patients were in remission and treated with biologicals, which could create bias in the sense of reducing the atherosclerotic risk directly correlated with active inflammation. |
| format | Article |
| id | doaj-art-a50baecd866d4bc89cc87dfe1e6f3498 |
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| issn | 1223-0472 2360-2473 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | Bucharest College of Physicians |
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| series | Modern Medicine |
| spelling | doaj-art-a50baecd866d4bc89cc87dfe1e6f34982025-08-20T01:59:34ZengBucharest College of PhysiciansModern Medicine1223-04722360-24732022-06-01292123127https://doi.org/10.31689/rmm.2021.29.2.123Early Atherosclerosis and Acute Vascular Events in Ulcerative Colitis Patients – a Case SeriesAna Maria NEGREANU0https://orcid.org/0000-0003-1037-3014Ana STEMATE1https://orcid.org/0000-0003-2935-5406Teodora SPATARU2Lucian NEGREANU3https://orcid.org/0000-0003-3042-0754Department of Internal Medicine I-Gastroenterology, Emergency University Hospital, „Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Internal Medicine I-Gastroenterology, Emergency University Hospital, „Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Internal Medicine I-Gastroenterology, Emergency University Hospital, „Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaDepartment of Internal Medicine I-Gastroenterology, Emergency University Hospital, „Carol Davila” University of Medicine and Pharmacy, Bucharest, RomaniaIntroduction: In inflammatory bowel disease uncontrolled inflammation may play a role in the early progression of systemic atheromatosis with increased cardiovascular risk. Endothelial dysfunction is mediated by pro-inflammatory cytokines but also by an increased level of CRP which is involved in the expression of adhesion molecules and atheroma plaque rupture. Tailored treatment with better control of the ulcerative colitis and endoscopic healing might result in decrease risk of atherothrombotic events. Aim: We decided to use a well-established method (vascular Doppler ultrasound with media-intimate index measurement) to detect an increased incidence of endothelial lesions as predictors of early atheromatosis in patients with ulcerative colitis treated with biological or conventional therapy. Material and methods: We prospectively analyzed 25 patients with RCUH with a mean age of 40 years, 16 with biological treatment. The Student t test, the Mann Whitney U test and the ANOVA test were used to compare continuous variables. Results: A discriminant analysis was performed with the presence of atheroma plaque as a dependent variable and several predictor variables, such as age, triglycerides, cholesterol of patients with ulcerative colitis. Univariate ANOVA analyzes revealed that the presence or absence of atheroma plaque differs in the variables predicting the age, INR and ecoIMT of patients with ulcerative colitis (in the age of patients (F = 8.511, degrees of freedom = 11, p = 0.014) Patients ‚INR (F = 50,437, degrees of freedom = 11, p = 0.001) and Patients’ ecoIMT (F = 7,398, degrees of freedom = 11, p = 0.020) In another analysis of discriminatory function s -introduced the predictor variables specific to measuring the evolution of ulcerative colitis, respectively Mayo and Mayo E (age (F = 0.8511, degrees of freedom = 11, p = 0.014), INR (F = 50.437, degrees of freedom = 11, p = 0.001), ecoIMT (F = 7.398, df = 11, p = 0.020) and Mayo (F = 14.885, degrees of freedom = 11, p = 0.003). Conclusions: Age, endoscopic activity, and INR were correlated with predictive ultrasound changes for atheromatosis. Strengths are the prospective nature of the study and weaknesses are the limited number of patients and the fact that most patients were in remission and treated with biologicals, which could create bias in the sense of reducing the atherosclerotic risk directly correlated with active inflammation.https://medicinamoderna.ro/wp-content/uploads/2022/06/Early-Atherosclerosis-and-Acute-Vascular-Events-in-Ulcerative-Colitis-Patients-%E2%80%93-a-Case-Series.pdfinflammatory bowel diseasesulcerative colitisinflammationatherosclerosiscarotid ultrasoundintima media thicknesscardiovascular risk |
| spellingShingle | Ana Maria NEGREANU Ana STEMATE Teodora SPATARU Lucian NEGREANU Early Atherosclerosis and Acute Vascular Events in Ulcerative Colitis Patients – a Case Series Modern Medicine inflammatory bowel diseases ulcerative colitis inflammation atherosclerosis carotid ultrasound intima media thickness cardiovascular risk |
| title | Early Atherosclerosis and Acute Vascular Events in Ulcerative Colitis Patients – a Case Series |
| title_full | Early Atherosclerosis and Acute Vascular Events in Ulcerative Colitis Patients – a Case Series |
| title_fullStr | Early Atherosclerosis and Acute Vascular Events in Ulcerative Colitis Patients – a Case Series |
| title_full_unstemmed | Early Atherosclerosis and Acute Vascular Events in Ulcerative Colitis Patients – a Case Series |
| title_short | Early Atherosclerosis and Acute Vascular Events in Ulcerative Colitis Patients – a Case Series |
| title_sort | early atherosclerosis and acute vascular events in ulcerative colitis patients a case series |
| topic | inflammatory bowel diseases ulcerative colitis inflammation atherosclerosis carotid ultrasound intima media thickness cardiovascular risk |
| url | https://medicinamoderna.ro/wp-content/uploads/2022/06/Early-Atherosclerosis-and-Acute-Vascular-Events-in-Ulcerative-Colitis-Patients-%E2%80%93-a-Case-Series.pdf |
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