P191 AORTIC STIFFNESS AND INFLAMMATION IN INFLAMMATORY BOWEL DISEASES: AN INDIVIDUAL PARTICIPANT DATA META-ANALYSIS

Abstract

Importance: The finding that aortic pulse wave velocity (aPWV) is increased may explain why patients with inflammatory bowel disease (IBD) have an increased cardiovascular risk despite the low prevalence of classic cardiovascular risk factors. Objective: To determine why these patients have an increased aPWV. Data sources: A systematic literature search for aPWV in IBD was performed using PubMed, Scopus, Web of Science, and Google Scholar databases. Study selection: Inclusion criterion was peer-reviewed publications on clinical studies reporting original data. Data extraction and synthesis: This study followed PRISMA-IPD 2015 guidelines. Data were provided for 4 cohorts in 3 countries (151 participants with ulcerative colitis [UC], 159 with Crohn disease [CD], and 227 controls). Using aPWV, cohort-specific z-scores were calculated after loge-transform and combined in meta-analysis to form pooled effects using a random- effects model. Main outcome and measures: The aPWV, a reference measure of aortic stiffness, after adjusting for age, sex, mean blood pressure, known cardiovascular risk factors, and study of origin. Results: The pooled z-score was 1.2 m/s. The aPWV was dependent on CD (β 0.80 z-score [1.0 m/s], 95% confidence interval 0.61–1.00 z-score, P < 0.001) and UC (β 0.69 z- score [0.8 m/s], 95% confidence interval 0.49–0.88 z-score, P < 0.001). In patients with IBD, the aPWV was dependent on disease duration (square root [years], β 0.15 z- score, 95% confidence interval 0.02–0.29 z-score, P = 0.03) and white blood cell count (Loge [billion cells/L], β 0.48 z-score, 95% confidence interval 0.12–0.84 z-score, P = 0.01) but not on cardiovascular risk factors and therapy. Conclusions: The increased aPWV reported in this patient population is dependent on inflammation.