Atherosclerotic Cardiovascular Disease in Inflammatory Bowel Disease: The Role of Chronic Inflammation and Platelet Aggregation

Abstract

Background and Objectives: Atherosclerosis is one of inflammatory bowel disease's most significant cardiovascular manifestations. This research aimed to examine the relationship between biochemical, haemostatic, and immune parameters of atherosclerosis and ulcerative colitis patients and its relationship to platelet aggregation. Materials and Methods: A clinical, observational cross-sectional study was performed, during which the tested parameters were compared in the experimental and control groups. The patients were divided into four groups. The first group had 25 patients who had ulcerative colitis and atherosclerosis. The second group included 39 patients with ulcerative colitis without atherosclerosis. The third group comprised 31 patients suffering from atherosclerosis without ulcerative colitis, and the fourth group comprised 25 healthy subjects. Results: In our study, we registered statistically higher levels of inflammatory markers like SE, CRP, Le, fecal calprotectin, TNF-α, and IL-6, as well as the higher value of thrombocytes and thrombocyte aggregation in the group of patients with ulcerative colitis compared to the control group. Lower levels of total cholesterol and LDL were also recorded in patients with ulcerative colitis and atherosclerosis and ulcerative colitis without atherosclerosis compared to healthy control. Triglyceride and remnant cholesterol were higher in patients with ulcerative colitis and atherosclerosis when compared to patients with ulcerative colitis and healthy control but lower than in patients with atherosclerosis only. Conclusions: Several inflammatory markers and platelet aggregation could be good discrimination markers for subjects with ulcerative colitis with the highest risk of atherosclerosis.

Keywords: atherosclerosis; inflammation; ulcerative colitis.

Figure 1

(A) ROC curve showing the relationship between sensitivity and specificity of CRP in patients with ulcerative colitis and its influence on the development of atherosclerosis (AUC = 0.742, sensitivity 76.0%, specificity 67.2%). (B) ROC curve showing the relationship between sensitivity and specificity of IL-6 in patients with ulcerative colitis and its influence on the development of atherosclerosis (AUC = 0.640, sensitivity 60.0%, specificity 71.6%). (C) ROC curve showing the relationship between sensitivity and specificity of TNF-α in patients with ulcerative colitis and its influence on the development of atherosclerosis. (AUC = 0.733, sensitivity 66.7%, specificity 73.8%). (D) ROC curve showing the relationship between sensitivity and specificity of Ag PLT ADP in patients with ulcerative colitis and its influence on the development of atherosclerosis (AUC = 0.753, sensitivity 93.3%, specificity 55.2%). (E) ROC curve showing the relationship between sensitivity and specificity of Ag PLT ASPI in patients with ulcerative colitis and its influence on the development of atherosclerosis (AUC = 0.755, sensitivity 88.6%, specificity 62.5%). (F) ROC curve showing the relationship between sensitivity and specificity of Ag PLT TRAP in patients with ulcerative colitis and its influence on the development of atherosclerosis (AUC = 0.753, sensitivity 85.3%, specificity 70.8%).