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

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Abstract

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.

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Abbreviations

IBD:

Inflammatory bowel disease

HDL:

High-density lipoprotein

LDL:

Low-density lipoprotein

RT:

Reactive thrombocytosis

CD:

Crohn’s disease

UC:

Ulcerative colitis

BMI:

Body mass index

References

  1. Santhosh-Kumar CR, Yohannan MD, Higgy KE, al-Mashhadani SA. Thrombocytosis in adults: analysis of 777 patients. J Intern Med. 1991;229:493–495.

    Article  CAS  PubMed  Google Scholar 

  2. Heits F, Stahl M, Ludwig D, Stange EF, Jelkmann W. Elevated serum thrombopoietin and interleukin-6 concentrations in thrombocytosis associated with inflammatory bowel disease. J Interferon Cytokine Res. 1999;19:757–760.

    Article  CAS  PubMed  Google Scholar 

  3. Kapsoritakis AN, Potamianos SP, Sfiridaki AI, et al. Elevated thrombopoietin serum levels in patients with inflammatory bowel disease. Am J Gastroenterol. 2000;95:3478–3481.

    Article  CAS  PubMed  Google Scholar 

  4. Collins CE, Rampton DS. Platelet dysfunction: a new dimension in inflammatory bowel disease. Gut. 1995;36:5–8.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Virmani R, Popovsky MA, Roberts WC. Thrombocytosis, coronary thrombosis and acute myocardial infarction. Am J Med. 1979;67:498–506.

    Article  CAS  PubMed  Google Scholar 

  6. Dumrongmongcolgul N, Mankongpaisarnrung C, Sutamtewagul G, Hosiriluck N, Chen T, Trujillo A, et al. Reactive thrombocytosis associated with acute myocardial infarction following STEMI with percutaneous coronary intervention. Case Rep Cardiol. 2013;2013:707438. doi:10.1155/2013/707438.

    PubMed Central  PubMed  Google Scholar 

  7. Yarur AJ, Deshpande AR, Pechman DM, Tamariz L, Abreu MT, Sussman DA. Inflammatory bowel disease is associated with an increased incidence of cardiovascular events. Am J Gastroenterol. 2011;106:741–747.

    Article  PubMed  Google Scholar 

  8. Aggarwal A, Atreja A, Kapadia S, Lopez R, Achkar J-P. Conventional risk factors and cardiovascular outcomes of patients with inflammatory bowel disease with confirmed coronary artery disease. Inflamm Bowel Dis. 2014;20:1593–1601.

    Article  PubMed  Google Scholar 

  9. D’Agostino RB, Vasan RS, Pencina MJ, et al. General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation. 2008;117:743–753.

    Article  PubMed  Google Scholar 

  10. Danese S, de la Motte CC, Fiocchi C. Platelets in inflammatory bowel disease: clinical, pathogenic, and therapeutic implications. Am J Gastroenterol. 2004;99:938–945.

    Article  PubMed  Google Scholar 

  11. Ridker PM, Buring JE, Rifai N, Cook NR. Development and validation of improved algorithms for the assessment of global cardiovascular risk in women: the Reynolds Risk Score. JAMA. 2007;297:611–619.

    Article  CAS  PubMed  Google Scholar 

  12. Van Sommeren S, Janse M, Karjalainen J, et al. Extraintestinal manifestations and complications in inflammatory bowel disease: from shared genetics to shared biological pathways. Inflamm Bowel Dis. 2014;20:987–994.

    PubMed  Google Scholar 

  13. Sartor RB. Mechanisms of disease: pathogenesis of Crohn’s disease and ulcerative colitis. Nat Clin Pract Gastroenterol Hepatol. 2006;3:390–407. doi:10.1038/ncpgasthep0528.

    Article  CAS  PubMed  Google Scholar 

  14. Duerschmied D, Bode C, Ahrens I. Immune functions of platelets. Thromb Haemost. 2014;112:678–691.

    Article  PubMed  Google Scholar 

  15. Voudoukis E, Karmiris K, Oustamanolakis P, et al. Association between thrombocytosis and iron deficiency anemia in inflammatory bowel disease. Eur J Gastroenterol Hepatol. 2013;25:1212–1216.

    CAS  PubMed  Google Scholar 

  16. Siddiqui TI, Kumar KSA, Dikshit DK. Platelets and atherothrombosis: causes, targets and treatments for thrombosis. Curr Med Chem. 2013;20:2779–2797.

    Article  CAS  PubMed  Google Scholar 

  17. Kristensen SL, Ahlehoff O, Lindhardsen J, et al. Disease activity in inflammatory bowel disease is associated with increased risk of myocardial infarction, stroke and cardiovascular death—a Danish nationwide cohort study. PLoS One. 2013;8:e56944.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Tousoulis D, Charakida M, Stefanadis C. Endothelial function and inflammation in coronary artery disease. Postgrad Med J. 2008;84:368–371.

    Article  CAS  PubMed  Google Scholar 

  19. Roifman I, Beck PL, Anderson TJ, Eisenberg MJ, Genest J. Chronic inflammatory diseases and cardiovascular risk: a systematic review. Can J Cardiol. 2011;27:174–182.

    Article  PubMed  Google Scholar 

  20. Srinivas M, Basumani P, Muthusamy R, Wheeldon N. Active inflammatory bowel disease and coronary artery dissection. Postgrad Med J. 2005;81:68–70.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. Singh S, Singh H, Loftus E V, Pardi DS. Risk of cerebrovascular accidents and ischemic heart disease in patients with inflammatory bowel disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2014;12:382–93.e1: quiz e22.

  22. Osterman MT, Yang Y-X, Brensinger C, Forde KA, Lichtenstein GR, Lewis JD. No increased risk of myocardial infarction among patients with ulcerative colitis or Crohn’s disease. Clin Gastroenterol Hepatol. 2011;9:875–880.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Basu D, Lopez I, Kulkarni A, Sellin JH. Impact of race and ethnicity on inflammatory bowel disease. Am J Gastroenterol. 2005;100:2254–2261.

    Article  PubMed  Google Scholar 

  24. Tefferi A, Barbui T. Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management. Am J Hematol. 2015;90:162–173.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA

    Sudeep Dhoj Thapa, Hiba Hadid, Waseem Imam, Ahmad Hassan & Muhammad Usman

  2. Department of Gastroenterology, Henry Ford Hospital, Detroit, MI, USA

    Syed-Mohammed Jafri & Jason Schairer

Authors
  1. Sudeep Dhoj Thapa
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  2. Hiba Hadid
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  3. Waseem Imam
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  4. Ahmad Hassan
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  5. Muhammad Usman
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  6. Syed-Mohammed Jafri
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  7. Jason Schairer
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Correspondence to Sudeep Dhoj Thapa.

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Thapa, S.D., Hadid, H., Imam, W. et al. Persistent Reactive Thrombocytosis May Increase the Risk of Coronary Artery Disease Among Inflammatory Bowel Disease Patients. Dig Dis Sci 60, 3062–3068 (2015). https://doi.org/10.1007/s10620-015-3701-1

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  • DOI: https://doi.org/10.1007/s10620-015-3701-1

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