Original articleSystematic reviews and meta-analysesRisk of Cerebrovascular Accidents and Ischemic Heart Disease in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-analysis
Section snippets
Methods
This systematic review was conducted following guidance provided by the Cochrane handbook20 and is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.21 The process followed an a priori established protocol.
Search Results
Among 688 unique studies that were identified using our search strategy, 9 studies met the defined inclusion criteria for this meta-analysis (6 case-control and 3 cohort studies).8, 11, 12, 13, 14, 15, 28, 29, 30 Three cross-sectional studies that reported the prevalence of CVA, IHD, and peripheral artery disease in patients with IBD were excluded.31, 32, 33 Figure 1 summarizes the process of study identification, inclusion, and exclusion. These studies cumulatively reported 2424 CVA, 6478 IHD,
Discussion
Previous systematic reviews have not shown a significant association between IBD (CD or UC) and cardiovascular mortality.16, 17, 18 In a recent meta-analysis of cause-specific standardized mortality ratios in population-based and inception cohort studies of patients with IBD, Bewtra et al35 observed that neither CD nor UC were associated with increased cardiovascular mortality in patients with IBD. Although cardiovascular mortality is a hard end point and less prone to ascertainment bias, it
Acknowledgment
S.S. and H.S. contributed equally to this work.
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This article has an accompanying continuing medical education activity on page e22. Learning Objectives—At the end of this activity, the successful learner will be able to recognize the association between inflammatory bowel diseases and risk of cerebrovascular accidents and ischemic heart disease.
Conflicts of interest The authors disclose no conflicts.