Thapa Sudeep Dhoj, Hadid Hiba, Imam Waseem, Hassan Ahmad, Usman Muhammad, Jafri Syed-Mohammed, Schairer Jason
Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA.
Department of Gastroenterology, Henry Ford Hospital, Detroit, MI, USA.
Dig Dis Sci. 2015 Oct;60(10):3062-8. doi: 10.1007/s10620-015-3701-1. Epub 2015 May 14.
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.
The aim of our study was to investigate the effect of persistent reactive thrombocytosis on the development of coronary artery disease in IBD.
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.
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.
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.
在没有传统风险因素的情况下，炎症性肠病（IBD）患者患冠状动脉疾病的风险增加。然而，尽管炎症增加似乎会增加IBD患者的心血管疾病风险，但与疾病相关的风险因素仍知之甚少。血小板参与冠状动脉疾病的发病机制，并且一部分IBD患者存在反应性血小板增多。
我们研究的目的是调查持续性反应性血小板增多对IBD患者冠状动脉疾病发生的影响。
我们评估了2000年至2004年在亨利福特医院接受评估的2525例IBD患者的回顾性队列。我们进行了一项病例对照研究，比较了持续性血小板增多患者和无持续性血小板增多患者。病例组（n = 36）和对照组（n = 72）按年龄和性别匹配。比较两组之间冠状动脉疾病的发病率。
病例组（n = 36）和对照组（n = 72）按年龄和性别匹配。病例组和对照组在IBD发病年龄（41.5对35.5，p值0.11）和吸烟状况（33.3对27.8%，p值0.66）方面相似。持续性血小板增多在白种人患者中较少见（44.44对62.5%，p值0.09），在研究随访期间接触过类固醇的患者中更常见。持续性血小板增多的患者中有13例（36.1%）发生冠状动脉疾病，而对照组中只有7例（9.7%）。
IBD患者中的持续性反应性血小板增多与冠状动脉疾病风险增加有关。进一步的研究应描述这种现象的临床和分子关联，并确定适当的治疗措施。
