Prevalence of hypercoagulable disorders in inflammatory bowel disease. (March 2014)

• Record Type: Journal Article
• Authors: Kohoutova, Darina; Pecka, Miroslav; Cihak, Michal; Cyrany, Jiri; Maly, Jaroslav; Bures, Jan
• Is Part Of: Scandinavian journal of gastroenterology. Volume 49:Number 3(2014)
• Page Start: 287
• Page End: 294
• Publication Date: 2014-03
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2013.870597
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Objective.</italic> </bold> Inflammatory bowel disease (IBD) can be associated with hypercoagulable disorders. Aim of this single-center, prospective study was an in-depth evaluation of acquired hypercoagulable states in IBD patients. <bold><italic>Methods. </italic></bold>A total of 110 patients with Crohn's disease (CD) (aged 19–69; mean 40.5, median 38.5 years), 43 with ulcerative colitis (UC) (aged 17–72; mean 42, median 36 years), and 30 controls were enrolled. Full blood count, serum C-reactive protein (CRP), proteins C and S, activated protein C (APC) resistance, thrombin–antithrombin complex (TAT), F1+F2 fragments, tissue factor pathway inhibitor (TFPI) total and truncated, TFPI-factor Xa, tissue plasminogen activator (tPA) and PAI-I antigen were investigated in peripheral blood samples. <bold><italic>Results.</italic></bold> Only 18 of 153 (11.8%) IBD patients had hemocoagulation parameters within normal range. Significant difference between IBD patients and controls was found in thrombocyte volume (<italic>p</italic> < 0.001), protein C (<italic>p</italic> = 0.025), protein S (<italic>p</italic> = 0.003), APC resistance (<italic>p</italic> < 0.001), F1+F2 fragments (<italic>p</italic> < 0.001), and tPA (<italic>p</italic> = 0.002). In CD patients who were divided into two subgroups according to serum CRP values (non-active disease: <5 mg/L; active disease ≥5 mg/L), thrombocyte count was significantly lower (<italic>p</italic> = 0.001), thrombocyte volume was significantly higher (<italic>p</italic> = 0.002), F1+F2 fragments were significantly lower (<italic>p</italic> = 0.007) and tPA was significantly higher (<italic>p</italic> = 0.038) in the subgroup with CRP <5 mg/L. In UC patients, no significant difference depending on CRP was found. <bold><italic>Conclusions. </italic></bold>Acquired hypercoagulable abnormalities in IBD patients are frequent. Patients with active CD, but not UC, displayed significantly different hemocoagulable parameters, when compared to non-active CD/UC subjects. In patients with active CD (with increased serum CRP concentration) and patients with active extensive UC found at endoscopy (despite low CRP values), prophylactic anticoagulation therapy should be considered.</p> </abstract>