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Selected Platelet Parameters in Patients with Rheumatoid Arthritis at Total Hip Arthroplasty

A.S. Ershov1,2, I.P. Antropova1,3, E.A. Volokitina1, L.P. Evstigneeva1,2

1Ural State Medical University, the Ministry of Health of the Russian Federation, Ekaterinburg, Russian Federation, 2Sverdlovsk Regional Clinical Hospital, Ekaterinburg, Russian Federation, 3Institute of High-Temperature Electrochemistry of the Ural Branch of the Russian Academy of Science, Ekaterinburg, Russian Federation

Abstract Number: PB0767

Meeting: ISTH 2021 Congress

Theme: Role of Hemostatic System in Cancer, Inflammation and Immunity » Platelets and Inflammation

Background: Platelets link with inflammation. However, data describing the effect of rheumatoid arthritis (RA) on  platelet morpho-functional parameters are contradictory.

Aims: The aim of the study was to determine the effect of rheumatoid arthritis on platelet parameters at primary total hip arthroplasty (THA).

Methods: The prospective study included 23 patients with RA and 21 patients with osteoarthritis (OA) underwent total hip arthroplasty. The groups had no significantly differ in gender, age, stage of the disease, concomitant pathology, type of surgical intervention, prosthesis fixation method,   implantation system type. Crystalloids were carried out intraoperatively in all patients according standard scheme. There were no blood transfusions. Blood indicators were studied using the Sysmex XT-4000i automatic hematology analyzer. Samples were analyzed within 1 hour after venipuncture to exclude platelet swelling. “Statistica” data analysis package was used for statistical processing.

Results: According Table 1, before THA red blood cell count and the level of hemoglobin were lower in the RA group against OA group; platelet count was higher in the RA group in comparison to OA group, but MPV in RA group was lower than in OA group. After surgery, there were no differences in red blood cells and hemoglobin levels in groups. The decreased level of red blood cells was significantly less in RA group compared with OA group; the decrease in hemoglobin level was also less in the RA group (Figure).
In patients with RA, there is a positive correlation between leukocyte count and platecrit (Spearman’s ρ=0.48; p<0.05) and negative correlation between white blood cell count and MPV (ρ=-0.43; p<0.05).

Parameter Before surgery 1 Day after surgery
RA OA p RA OA p
Red blood cells(х106/µL) 4.37 [4.10; 4.68] 4.75 [4.30; 4.98] 0.086 3.65 [3.23; 4.01] 3.71 [3.27; 4.03] 0.839
Hemoglobin (g/L) 133.0 [119.0; 136.0] 140.0 [124.0; 146.0] 0.031 107.0 [103.0; 113.0] 107.0 [102.0; 116.0] 0.228
Platelets (х103/ µL) 257.0 [233.0; 306.0] 219.0 [178.0; 262.0] 0.026 213.0 [174.0; 267.0] 170.0 [146.0; 225.0] 0.025
MPV (fL) 8.7 [8.3; 10.0] 9.9 [9.1; 10.8] 0.043 9.8 [8.6; 10.6] 10.1 [9.5; 10.5] 0.170

Hematological parameters in patients with RA and OA before and 1 day after total hip arthroplasty. Results are presented as median [interquartile range]
Loss of red blood cells (A) and hemoglobin (B) at total hip arthroplasty in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Results are presented as median [interquartile range]

Conclusions: In RA patients requiring THA, platelet parameters are associated with leukocyte count and possibly inflammation. Platelets morpho-functional features in RA may contribute to a lower loss of red blood compared to patients with OA at surgery.

To cite this abstract in AMA style:

Ershov AS, Antropova IP, Volokitina EA, Evstigneeva LP. Selected Platelet Parameters in Patients with Rheumatoid Arthritis at Total Hip Arthroplasty [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/selected-platelet-parameters-in-patients-with-rheumatoid-arthritis-at-total-hip-arthroplasty/. Accessed May 16, 2022.

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