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Augmentation index is increased in patients with inflammatory bowel disease, a meta-analysis

Published:December 22, 2016DOI:https://doi.org/10.1016/j.ejim.2016.12.012
      In a work published in a recent issue of the European Journal of Internal Medicine [
      • Cappello M.
      • Licata A.
      • Calvaruso V.
      • et al.
      Increased expression of markers of early atherosclerosis in patients with inflammatory bowel disease.
      ], Cappello et al. found that, despite the lower prevalence of dyslipidemia, carotid-femoral pulse wave velocity, a measure of arterial stiffness, and augmentation index, a measure of wave reflection, were significantly increased in patients with inflammatory bowel disease (IBD), a disease characterized by chronic inflammation. This finding confirms the results of our previous works [
      • Zanoli L.
      • Cannavò M.
      • Rastelli S.
      • et al.
      Arterial stiffness is increased in patients with inflammatory bowel disease.
      ,
      • Zanoli L.
      • Rastelli S.
      • Inserra G.
      • et al.
      Increased arterial stiffness in inflammatory bowel diseases is dependent upon inflammation and reduced by immunomodulatory drugs.
      ] and is of clinical interest because it helps explain why IBD patients have an increased cardiovascular risk despite the low prevalence of traditional cardiovascular risk factors [
      • Zanoli L.
      • Inserra G.
      • Castellino P.
      Increased cardiovascular risk in subjects with a low prevalence of classic cardiovascular risk factors: the inflammatory bowel disease paradox.
      ]. In this regard, the significantly higher augmentation index reported by Cappello et al. in IBD patients treated with salicylates are consistent with current evidences showing that chronic inflammation could play a role in the arterial stiffening of patients with IBD [
      • Zanoli L.
      • Cannavò M.
      • Rastelli S.
      • et al.
      Arterial stiffness is increased in patients with inflammatory bowel disease.
      ,
      • Zanoli L.
      • Rastelli S.
      • Inserra G.
      • et al.
      Increased arterial stiffness in inflammatory bowel diseases is dependent upon inflammation and reduced by immunomodulatory drugs.
      ,
      • Zanoli L.
      • Inserra G.
      • Castellino P.
      Increased cardiovascular risk in subjects with a low prevalence of classic cardiovascular risk factors: the inflammatory bowel disease paradox.
      ,
      • Zanoli L.
      • Rastelli S.
      • Granata A.
      • et al.
      Arterial stiffness in inflammatory bowel disease: a systematic review and meta-analysis.
      ,
      • Zanoli L.
      • Rastelli S.
      • Inserra G.
      • Castellino P.
      Arterial structure and function in inflammatory bowel disease.
      ]. This finding is also in accordance with the results of two recent meta-regression analyses that has suggested a lack of efficacy of salicylates in protecting IBD patients from arterial stiffening [

      Zanoli L, Boutouyrie P, Lentini P, et al. Maintenance therapy with salicylates is associated with aortic stiffening in patients with inflammatory bowel disease. J Hypertens [in press]. http://dx.doi.org/10.1097/HJH.0000000000001235.

      ] and the destiffening effect of anti-tumor necrosis factor α (anti-TNFα) therapy [
      • Zanoli L.
      • Rastelli S.
      • Granata A.
      • et al.
      Arterial stiffness in inflammatory bowel disease: a systematic review and meta-analysis.
      ].

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