P2159 - Evaluating Subclinical Atherosclerosis Using Vascular Parameters in Inflammatory Bowel Disease Patients: A Meta-Analysis

Vagisha Sharma, MBBS¹, Rukesh Yadav, MBBS², Chandan Kumar. Dash, MBBS, MD³, Rohit Goyal, MBBS⁴, Sana Dang, MBBS⁵, Harendra Kumar, MBBS⁶, Nikita Garg, MBBS⁷, Karan Sachdeva, MBBS⁴, Mansunderbir Singh, MBBS⁴, Tanvi Grover, MBBS, MD⁸, Vikash Jaiswal, MD⁹, Kaumudi Somnay, MD, FACG^10
1Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, Delhi, India; ²Maharajgunj Medical Campus, Kathmandu, Bagmati, Nepal; ³Allegheny General Hospital, Pittsburgh, PA; ⁴Louisiana State University, Shreveport, LA; ⁵SUNY Upstate Medical, Syracuse, NY; ⁶Dow University of Health Sciences, Karachi, Sindh, Pakistan; ⁷Marshfield Medical Center, Marshfield, WI; ⁸Raritan Bay Medical Center, Perth Amboy, NJ; ⁹Larkin Community Hospital, South Miami, FL; ¹⁰Mercy Hospital-Rockville Centre (Catholic Health System), Rockville Centre, NY

Introduction: Recent research has shown that patients with inflammatory bowel disease (IBD) are at a higher risk of developing cardiovascular problems. However, there are conflicting results published concerning the variations in brachial artery flow mediated dilation(FMD), carotid intima-media thickness(cIMT) and carotid–femoral pulse wave velocity (cfPWV), which serve as an indicator of early-stage atherosclerosis. Our study sought to examine how these parameters are affected in IBD patients as compared to healthy controls.

Methods: We conducted a comprehensive search of the Google Scholar, Scopus, and PubMed databases, from January 1, 2014, to June 1, 2023, to gather relevant studies. Random effect model was used when heterogeneity (I Square ) crossed 50%. The pooled mean differences in various parameters between IBD patients and controls were calculated using the standard mean difference with 95% confidence interval (CI) in Revman Software 5.4.

Results: A total of 19 studies with 2563 participants were shortlisted for analysis. The FMD was significantly lower in Crohn's disease(CD) patients compared to healthy controls(SMD:-0.52 [-0.82,-0.23], p=0.0005), but no significant difference was found in ulcerative colitis(UC) patients and healthy controls(SMD:-0.35 [-1.11,0.42], p=0.38). The cIMT was significantly higher in IBD patients compared to healthy controls(SMD:0.41 [0.15, 0.67], p=0.002). The cfPWV was significantly higher in both UC patients compared to healthy controls(SMD:0.81 [0.49, 1.13], p< 0.00001) and in CD patients compared to healthy controls(OR:0.90 [0.56, 1.24], p< 0.00001).

Discussion: Our pooled analysis revealed that IBD patients are at an increased risk of subclinical atherosclerosis compared to healthy controls, as evidenced by higher measures of cIMT and cfPWV. These suggest an increased arterial stiffness, which is associated with increased atherosclerosis progression. Interestingly, flow-mediated dilation (FMD) showed variations among different IBD subtypes. While no significant difference was observed in FMD between UC patients and healthy controls, CD patients exhibited significantly lower FMD, suggesting impaired endothelial function and vasodilation capacity. Further research should focus on elucidating the mechanism underlying this difference. Due to the increased risk of subclinical atherosclerosis in IBD patients cardiovascular preventive measures should be incorporated in all patients and patients with traditional cardiovascular risk factors closely monitored.



Disclosures:


Vagisha Sharma, MBBS¹, Rukesh Yadav, MBBS², Chandan Kumar. Dash, MBBS, MD³, Rohit Goyal, MBBS⁴, Sana Dang, MBBS⁵, Harendra Kumar, MBBS⁶, Nikita Garg, MBBS⁷, Karan Sachdeva, MBBS⁴, Mansunderbir Singh, MBBS⁴, Tanvi Grover, MBBS, MD⁸, Vikash Jaiswal, MD⁹, Kaumudi Somnay, MD, FACG¹⁰. P2159 - Evaluating Subclinical Atherosclerosis Using Vascular Parameters in Inflammatory Bowel Disease Patients: A Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.