Skip to main content
Erschienen in: Digestive Diseases and Sciences 10/2015

01.10.2015 | Original Article

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

verfasst von: Sudeep Dhoj Thapa, Hiba Hadid, Waseem Imam, Ahmad Hassan, Muhammad Usman, Syed-Mohammed Jafri, Jason Schairer

Erschienen in: Digestive Diseases and Sciences | Ausgabe 10/2015

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Santhosh-Kumar CR, Yohannan MD, Higgy KE, al-Mashhadani SA. Thrombocytosis in adults: analysis of 777 patients. J Intern Med. 1991;229:493–495.CrossRefPubMed Santhosh-Kumar CR, Yohannan MD, Higgy KE, al-Mashhadani SA. Thrombocytosis in adults: analysis of 777 patients. J Intern Med. 1991;229:493–495.CrossRefPubMed
2.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
3.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
5.
Zurück zum Zitat Virmani R, Popovsky MA, Roberts WC. Thrombocytosis, coronary thrombosis and acute myocardial infarction. Am J Med. 1979;67:498–506.CrossRefPubMed Virmani R, Popovsky MA, Roberts WC. Thrombocytosis, coronary thrombosis and acute myocardial infarction. Am J Med. 1979;67:498–506.CrossRefPubMed
6.
Zurück zum Zitat 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.PubMedCentralPubMed 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.PubMedCentralPubMed
7.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
8.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
9.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
10.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
11.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
12.
Zurück zum Zitat 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 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
14.
Zurück zum Zitat Duerschmied D, Bode C, Ahrens I. Immune functions of platelets. Thromb Haemost. 2014;112:678–691.CrossRefPubMed Duerschmied D, Bode C, Ahrens I. Immune functions of platelets. Thromb Haemost. 2014;112:678–691.CrossRefPubMed
15.
Zurück zum Zitat 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.PubMed 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.PubMed
16.
Zurück zum Zitat Siddiqui TI, Kumar KSA, Dikshit DK. Platelets and atherothrombosis: causes, targets and treatments for thrombosis. Curr Med Chem. 2013;20:2779–2797.CrossRefPubMed Siddiqui TI, Kumar KSA, Dikshit DK. Platelets and atherothrombosis: causes, targets and treatments for thrombosis. Curr Med Chem. 2013;20:2779–2797.CrossRefPubMed
17.
Zurück zum Zitat 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.PubMedCentralCrossRefPubMed 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.PubMedCentralCrossRefPubMed
18.
Zurück zum Zitat Tousoulis D, Charakida M, Stefanadis C. Endothelial function and inflammation in coronary artery disease. Postgrad Med J. 2008;84:368–371.CrossRefPubMed Tousoulis D, Charakida M, Stefanadis C. Endothelial function and inflammation in coronary artery disease. Postgrad Med J. 2008;84:368–371.CrossRefPubMed
19.
Zurück zum Zitat 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.CrossRefPubMed 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.CrossRefPubMed
20.
Zurück zum Zitat Srinivas M, Basumani P, Muthusamy R, Wheeldon N. Active inflammatory bowel disease and coronary artery dissection. Postgrad Med J. 2005;81:68–70.PubMedCentralCrossRefPubMed Srinivas M, Basumani P, Muthusamy R, Wheeldon N. Active inflammatory bowel disease and coronary artery dissection. Postgrad Med J. 2005;81:68–70.PubMedCentralCrossRefPubMed
21.
Zurück zum Zitat 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. 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.
Zurück zum Zitat 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.PubMedCentralCrossRefPubMed 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.PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Basu D, Lopez I, Kulkarni A, Sellin JH. Impact of race and ethnicity on inflammatory bowel disease. Am J Gastroenterol. 2005;100:2254–2261.CrossRefPubMed Basu D, Lopez I, Kulkarni A, Sellin JH. Impact of race and ethnicity on inflammatory bowel disease. Am J Gastroenterol. 2005;100:2254–2261.CrossRefPubMed
24.
Zurück zum Zitat Tefferi A, Barbui T. Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management. Am J Hematol. 2015;90:162–173.CrossRefPubMed Tefferi A, Barbui T. Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management. Am J Hematol. 2015;90:162–173.CrossRefPubMed
Metadaten
Titel
Persistent Reactive Thrombocytosis May Increase the Risk of Coronary Artery Disease Among Inflammatory Bowel Disease Patients
verfasst von
Sudeep Dhoj Thapa
Hiba Hadid
Waseem Imam
Ahmad Hassan
Muhammad Usman
Syed-Mohammed Jafri
Jason Schairer
Publikationsdatum
01.10.2015
Verlag
Springer US
Erschienen in
Digestive Diseases and Sciences / Ausgabe 10/2015
Print ISSN: 0163-2116
Elektronische ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-015-3701-1

Weitere Artikel der Ausgabe 10/2015

Digestive Diseases and Sciences 10/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.