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OBJECTIVES:Inflammation in general, and C-reactive protein (CRP) in particular, areclosely associated with atherosclerosis. Similarly, the risk of cardiovascular(CV) disease is increased in several systemic inflammatory diseases. Thepurpose of this study was to examine whether inflammatory bowel disease (IBD)increases CV mortality, an indirect surrogate for CV disease incidence.METHODS: A systematic review of studies on CV mortality rates in patients withIBD published between 1965 and 2006 was performed. Studies were included foranalysis if they reported data on CV-disease-specific standardized mortalityratios (SMRs) for Crohn's disease (CD) and/or ulcerative colitis (UC). Ameta-analysis of SMRs from included studies was performed. RESULTS: The reviewultimately included 11 studies. Overall there were 4,532 patients with CD and9,533 patients with UC. SMR point estimates ranged from 0.7 to 1.5 for patientswith CD and 0.6-1.1 for patients with UC. There was not a statisticallysignificant increase in CV SMR for either CD or UC in any study. However, twostudies demonstrated a statistically significant decrease in CV SMR for UC.Finally, the meta-SMR for CD was 1.0 (95% CI 0.8-1.1) and the meta-SMR for UCwas 0.9 (95% CI 0.8-1.0). CONCLUSIONS: IBD is not associated with increased CVmortality. Although CV mortality is a suboptimal surrogate for CV diseaseincidence, this finding provides indirect evidence against an associationbetween IBD and CV disease.Leggil'articolo