Venous Thromboembolism Among Patients With Inflammatory Bowel Diseases is Not Related to Increased Thrombophilia: A Case-Control Study. Issue 3 (March 2022)

• Record Type: Journal Article
• Authors: Ollech, Jacob E.; Waizbard, Amir; Lubetsky, Aaron; Kopylov, Uri; Goren, Idan; Dotan, Iris; Yanai, Henit
• Is Part Of: Journal of clinical gastroenterology. Volume 56:Issue 3(2022)
• Publication Date: 2022-03
• Subjects: thrombosis -- venous thromboembolic event -- thrombophilia -- provoked -- inflammation; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Digestive organs -- Diseases; Gastroenterology; Periodicals; Periodicals; 616.33005
• DOI: 10.1097/MCG.0000000000001578
• Languages: English
• ISSNs: 0192-0790

Abstract

Abstract : Goal: The aim was to assess whether thrombophilia significantly contributes to the risk of venous thromboembolic events (VTEs) in patients with inflammatory bowel disease (IBD). Background: Patients with IBD have a high risk of VTE. The underlying mechanism has been only partially defined. Methods: A case-control study in adults with IBD and an episode of VTE (IBD-VTE) were matched and compared with non–IBD patients with a VTE (non–IBD-VTE). The study population was comprised of patients seen in 2 tertiary medical centers in Israel between 2000 and 2013. Characteristics of IBD and risk factors for VTE were retrieved from medical charts, and a comprehensive thrombophilia panel was completed in all patients. Results: Forty-four IBD-VTE cases (27 Crohn's disease) were matched with 127 non–IBD-VTE controls. The majority of VTE had a clear etiology and were considered provoked events. Provoked and unprovoked VTE rates were not different between the 2 groups. Likewise, thrombophilia rates were similar among patients with IBD-VTE and controls (40.9% vs. 53.5%, respectively, P =0.14). However, among patients with unprovoked VTE, thrombophilia rates were significantly lower in the IBD-VTE group compared with controls (42.1% vs. 70.7%, respectively, P =0.03). Among patients with IBD-VTE, an unprovoked event, and negative thrombophilia, 77% had active inflammation at the time of VTE. Conclusion: Thrombophilia rates are similar among patients with IBD-VTE and controls but are less common among patients with unprovoked IBD-VTE. This finding suggests that either inflammation or other novel pathways drive VTE in patients with IBD.