Frequency and risk factors for thromboembolic complications in patients with inflammatory bowel diseases

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Abstract

Background. Inflammatory bowel diseases (IBD) are characterized by chronic immune inflammation of the mucous membrane and/or the thickness of the intestinal wall, and are also accompanied by disorders of the blood clotting system and the development of a hypercoagulation state.

Aim. To identify the frequency of thromboembolic complications (TEC) in IBD patients and to determine the influence of acquired and inherited hypercoagulation factors that contribute to the development of TEС.

Materials and methods. The clinical status of 1,238 IBD patients who were treated in 2019 was evaluated. Of these, 748 patients with ulcerative colitis (UC) and 490 patients with Crohn's disease (CD). Among UC patients, there were 369 (49.3%) men and 379 (50.7%) women. In 10.1% of patients with UC, there were clinically significant feasibility studies. There were 227 (46.3%) men and 263 (53.7%) women among patients with CD; 7.3% of patients with CD had clinically significant feasibility studies.

Results. In general 112 (9.0%) of 1,238 IBD patients had clinically significant feasibility studies. Among patients with UC (n=748), 76 (10.2%) showed clinically significant feasibility studies. Among patients with CD (n=490), 36 (7.3%) had a feasibility study. Of 112 IBD patients with clinically significant TEC, 45 (40.2%) had genetic polymorphisms that increase affinity for fibrinogen, increase platelet aggregation, and contribute to a decrease in the activity of folate cycle enzymes, including methylenetetrahydrofolate reductase, which may be manifested by a moderate increase in homocysteine levels. Of the 45 IBD patients with clinically significant TEC due to inherited factors, 30 (66.6%) patients had UC, 15 (33.7%) patients had CD (hazard ratio 1.038, 95% confidence interval 0.746–1.444; χ2=0.049; p=0.83921); 67 (59.8%) patients with IBD who had clinically significant TEC did not have genetic polymorphisms leading to hypercoagulation.

Conclusion. Based on the analysis, we can conclude that such risk factors for the development of TEC as the status of a smoker, long bed rest, taking hormonal contraceptives, varicose veins of the lower extremities, high activity of the disease, glucocorticoids therapy, the extent of intestinal damage in patients with IBD, genetic factors, should be taken into account by gastroenterologists in the treatment of patients with UC and CD. The hereditary factor of hypercoagulation equally affects the development of TEC, both in patients with UC and CD.

About the authors

Albina A. Lishchinskaya

Loginov Moscow Clinical Scientific Center

Email: oleg7@bk.ru
ORCID iD: 0000-0001-7891-2702

канд. мед. наук, ст. науч. сотр. отд-ния воспалительных заболеваний кишечника

Russian Federation, Moscow

Oleg V. Knyazev

Loginov Moscow Clinical Scientific Center; Ryzhykh National Medical Research Centre for Coloproctology; Research Institute of Health Organization and Medical Management

Author for correspondence.
Email: oleg7@bk.ru
ORCID iD: 0000-0001-7250-0977

д-р мед. наук, зав. отд-нием воспалительных заболеваний кишечника; проф. научно-образовательного отд.; вед. специалист организационно-методического отд. по колопроктологии

Russian Federation, Moscow; Moscow; Moscow

Anna V. Kagramanova

Loginov Moscow Clinical Scientific Center

Email: oleg7@bk.ru
ORCID iD: 0000-0002-3818-6205

канд. мед. наук, ст. науч. сотр. отд-ния воспалительных заболеваний кишечника

Russian Federation, Moscow

Galina A. Dudina

Loginov Moscow Clinical Scientific Center

Email: oleg7@bk.ru
ORCID iD: 0000-0001-9673-1067

д-р мед. наук, зав. отд-нием гематологии

Russian Federation, Moscow

Elena A. Sabelnikova

Loginov Moscow Clinical Scientific Center

Email: oleg7@bk.ru
ORCID iD: 0000-0001-7519-2041

д-р мед. наук, зам. дир. по науке

Russian Federation, Moscow

Irina A. Li

Loginov Moscow Clinical Scientific Center

Email: oleg7@bk.ru
ORCID iD: 0000-0002-9508-7502

д-р мед. наук, глав. врач

Russian Federation, Moscow

Karina K. Noskova

Loginov Moscow Clinical Scientific Center

Email: oleg7@bk.ru
ORCID iD: 0000-0001-5734-0995

канд. мед. наук, зав. клинико-диагностической лаб.

Russian Federation, Moscow

Natalia A. Bodunova

Loginov Moscow Clinical Scientific Center

Email: oleg7@bk.ru
ORCID iD: 0000-0002-3119-7673

канд. мед. наук, рук. центра персонализированной медицины

Russian Federation, Moscow

Asfold I. Parfenov

Loginov Moscow Clinical Scientific Center

Email: oleg7@bk.ru
ORCID iD: 0000-0002-9782-4860

д-р мед. наук, проф., рук. отд. патологии кишечника

Russian Federation, Moscow

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