Review Article

Cardiovascular Manifestations of Inflammatory Bowel Disease: Pathogenesis, Diagnosis, and Preventive Strategies

Table 3

Recommended preventive measures for cardiovascular EIM in IBD.

General measures
(i) Maintenance of remission for as long as possible
(ii) Regular cardiologic checkup
 (a) Physical examination
 (b) Blood pressure measurement
 (c) Blood tests (hemoleucogram, lipids, electrolytes, biomarkers of cardiac injury, B-type natriuretic peptide, and N-terminal probrain natriuretic peptide, acute phase reactants)
 (d) 12-lead electrocardiogram
 (e) Transthoracic echocardiography (including 2D speckle tracking for early detection of subclinical changes in cardiac function)
(iii) Reduce stress
(iv) Cease smoking
(v) Lose weight in case of obesity
(vi) Reduce hospitalization
(vii) Early mobilize the patients
(viii) Minimize the use of invasive devices
(ix) Reduce the consumption of oral contraceptives and hormone replacement therapy
(x) Minimize the duration of corticosteroid and immunosuppressant administration
(xi) Diet with low sodium intake and potassium supplementation while corticosteroid use

Specific measures
Venous thromboembolism [22, 59, 6466](i) Screening for genetic risk factors in patients with recurrent venous thromboembolic events
(ii) Prophylactic anticoagulation or mechanical thromboprophylaxis (when anticoagulation is contraindicated) and management of additional risk factors in hospitalized patients
(iii) Short-term or long-term anticoagulation should be decided according to each patient
Arterial thromboembolism [19, 8082](i) Management of traditional and nontraditional cardiovascular risk factors
Infective endocarditis [108, 109](i) Prophylactic antibiotherapy in case of preexisting valvulopathy, invasive procedures, or use of central venous catheters