Venous Thromboembolism Among Patients With Inflammatory Bowel Diseases is Not Related to Increased Thrombophilia: A Case-Control Study,Journal of Clinical Gastroenterology

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Venous Thromboembolism Among Patients With Inflammatory Bowel Diseases is Not Related to Increased Thrombophilia: A Case-Control Study
Journal of Clinical Gastroenterology ( IF 2.8 ) Pub Date : 2022-03-01 , DOI: 10.1097/mcg.0000000000001578
Jacob E Ollech _{1,

2} , Amir Waizbard _{2,

3} , Aaron Lubetsky _{2,

4} , Uri Kopylov _{2,

5} , Idan Goren _{1,

2} , Iris Dotan _{1,

2} , Henit Yanai _{1,

2}

Affiliation

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.

中文翻译：

炎症性肠病患者的静脉血栓栓塞与血栓形成倾向增加无关：病例对照研究

目标：

目的是评估血栓形成倾向是否显着增加炎症性肠病（IBD）患者静脉血栓栓塞事件（VTE）的风险。

背景：

IBD 患者发生 VTE 的风险很高。底层机制仅被部分定义。

方法：

一项针对成人 IBD 和 VTE 发作 (IBD-VTE) 的病例对照研究将其与患有 VTE 的非 IBD 患者 (non-IBD-VTE) 进行匹配和比较。研究人群由 2000 年至 2013 年间在以色列 2 个三级医疗中心就诊的患者组成。从病历中检索 IBD 的特征和 VTE 的危险因素，并对所有患者完成了全面的血栓形成倾向小组。

结果：

44 例 IBD-VTE 病例（27 例克罗恩病）与 127 例非 IBD-VTE 对照相匹配。大多数 VTE 都有明确的病因，被认为是诱发事件。两组之间诱发和非诱发的 VTE 发生率没有差异。同样，IBD-VTE 患者和对照患者的血栓形成倾向率相似（分别为 40.9% 和 53.5%，P = 0.14）。然而，在无诱因 VTE 的患者中，IBD-VTE 组的血栓形成率显着低于对照组（分别为 42.1% 和 70.7%，P = 0.03）。在患有 IBD-VTE（无端事件）和阴性血栓形成倾向的患者中，77%在 VTE 时患有活动性炎症。