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Platelet count as a potential predictor in refractory Takayasu arteritis

  • Observational Research
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Abstract

Platelet parameters have been recognized as important markers for disease severity in various types of diseases. The aim of our study was to investigate whether platelet count could be used as a potential predictor of refractory Takayasu arteritis (TAK). In this retrospective study, fifty-seven patients were selected as development data group to identify the associated risk factors and potential predictors of refractory TAK. Ninety-two TAK patients were included in the validation data group to verify the predictive value of platelet count for refractory TAK. Refractory TAK patients had higher levels of platelet (PLT) than non-refractory TAK patients (305.5 vs. 272.0 × 109/L, P = 0.043). For PLT, the best cut-off value was 296.5 × 109/L to predict refractory TAK. Elevated PLT (> 296.5 × 109/L) was found to be statistically related to refractory TAK (OR [95%CI] 4.000 [1.233–12.974], p = 0.021). In the validation data group, the proportion of refractory TAK in patients with elevated PLT was significantly higher than that in patients with non-elevated PLT (55.6% vs. 32.2%, P = 0.037). The 1-, 3- and 5-year cumulative incidence of refractory TAK were 37.0%, 44.4% and 55.6% in patients with elevated PLT, respectively. Elevated PLT (p = 0.035, hazard ratio (HR) 2.106) was identified as a potential predictor of refractory TAK. Clinicians should pay close attention to platelet levels in patients with TAK. For TAK patients with PLT greater than 296.5 × 109/L, closer monitoring of the disease and comprehensive assessment of disease activity are recommended to be alert to the occurrence of refractory TAK.

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Data availability

The datasets used and/or analyzed in the current study are available from the corresponding author upon reasonable request.

Abbreviations

TAK:

Takayasu arteritis

PLT:

Platelet

HR:

Hazard ratio

NIH:

National Institutes of Health

ITAS:

Indian Takayasu’s Arteritis Activity Score

ITAS-A:

ITAS with acute-phase reactants

hs-CRP:

High-sensitivity C-reactive protein

ESR:

Erythrocyte sedimentation rate

TNF-α:

Tumor necrosis factor alpha

IL:

Interleukin

Ig:

Immunoglobulin

WBC:

White blood cell

RBC:

Red blood cell

ROC:

Receiver-operating characteristic

PCT:

Platelet crit

MPV:

Mean platelet volume

PDW:

Platelet distribution width

P-LCR:

Platelet-large ratio

ALT:

Alanine transaminase

KD:

Kawasaki disease

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Funding

This project was supported by National Natural Science Foundation of China (No. 82270427; No. 81900448).

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Authors and Affiliations

  1. Department of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing, 100029, China

    Xuemei Shi, Juan Du, Taotao Li & Lili Pan

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  1. Xuemei Shi
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  2. Juan Du
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  3. Taotao Li
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  4. Lili Pan
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Contributions

LP and XS conceived and designed the study. XS, JD and TL contributed to the data collection. XS analyzed the data and drafted the paper. XS, TL and LP edited and revised the paper. All authors approved the final manuscript.

Corresponding author

Correspondence to Lili Pan.

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Conflict of interest

The authors have declared no conflicts of interest.

Ethical approval

The study was approved by the Ethics Committee of Beijing Anzhen Hospital (approval number: 2022158X). Given the retrospective design of our study, the requirement of written informed consent was exempted.

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Shi, X., Du, J., Li, T. et al. Platelet count as a potential predictor in refractory Takayasu arteritis. Rheumatol Int 43, 2251–2260 (2023). https://doi.org/10.1007/s00296-023-05368-5

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  • DOI: https://doi.org/10.1007/s00296-023-05368-5

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