Persistent Reactive Thrombocytosis May Increase the Risk of Coronary Artery Disease Among Inflammatory Bowel Disease Patients

• Published in: Digestive diseases and sciences 2015-10, Vol.60 (10), p.3062-3068
• Main Authors: Thapa, Sudeep Dhoj, Hadid, Hiba, Imam, Waseem, Hassan, Ahmad, Usman, Muhammad, Jafri, Syed-Mohammed, Schairer, Jason
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Analysis of Variance; Biochemistry; Case-Control Studies; Colitis, Ulcerative - epidemiology; Colitis, Ulcerative - physiopathology; Comorbidity; Confidence Intervals; Coronary Artery Disease - epidemiology; Coronary Artery Disease - physiopathology; Coronary heart disease; Crohn Disease - epidemiology; Crohn Disease - physiopathology; Development and progression; Female; Gastroenterology; Gastrointestinal diseases; Hepatology; Humans; Incidence; Inflammation; Inflammatory bowel disease; Inflammatory Bowel Diseases - epidemiology; Inflammatory Bowel Diseases - physiopathology; Logistic Models; Male; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Multivariate Analysis; Odds Ratio; Oncology; Original Article; Pneumoviridae; Prognosis; Retrospective Studies; Risk Assessment; Risk factors; Severity of Illness Index; Sex Distribution; Statistics, Nonparametric; Thrombocytosis - epidemiology; Thrombocytosis - physiopathology; Transplant Surgery
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-015-3701-1

Background IBD patients are at increased risk of coronary artery disease in the absence of traditional risk factors. However, the disease-related risk factors remain poorly understood although increased inflammation seems to increase cardiovascular disease risk in IBD. Thrombocytes are involved in the pathogenesis of coronary artery disease, and a subset of IBD patients have reactive thrombocytosis. Aim The aim of our study was to investigate the effect of persistent reactive thrombocytosis on the development of coronary artery disease in IBD. Methods We evaluated a retrospective cohort of 2525 IBD patients who were evaluated at the Henry Ford hospital from 2000 to 2004. We performed a case–control study comparing patients with persistent thrombocytosis and patients without persistent thrombocytosis. Cases ( n  = 36) and controls ( n  = 72) were matched for age and gender. Coronary artery disease incidence was compared between the two groups. Results Cases ( n  = 36) and controls ( n  = 72) were matched for age and gender. Cases and controls were similar in age at onset of IBD (41.5 vs. 35.5, p value 0.11) and smoking status (33.3 vs. 27.8 %, p value 0.66). Persistent thrombocytosis was less common among Caucasian patients (44.44 vs. 62.5 %, p value 0.09) and more common in patients who had exposure to steroids during the study follow-up period. Coronary artery disease occurred in 13 (36.1 %) patients with persistent thrombocytosis compared to only seven (9.7 %) patients in the control group. Conclusions Persistent reactive thrombocytosis among IBD patients is associated with increased risk of coronary artery disease. Further studies should characterize the clinical and molecular associations of this phenomenon and determine appropriate therapeutic measures.