Abstract Number: PB0105
Meeting: ISTH 2021 Congress
Background: Thrombosis risk is increased in Crohn disease (CD). thrombin generation assay (TGA) have been evaluated during CD in several studies but the results remain controversial.
Aims: Evaluate the hypercoagulable state in CD patients through TGA and correlate it with the clinical and biological status of the disease.
Methods: This was a comparative study, including 50 patients with CD and 50 matched controls according to age and sex. Data related to CD were collected. TGA parameters: Lag time, time to peak, peak, endogenous thrombin potential (ETP) and velocity index were analyzed. C reactive protein (CRP), fibrinogen and factor VIII (FVIII) were also investigated.
Results: Median age was 44years-old (29men and 21women). 66% of patients were in remission. The mean level of FVIII (285±175vs133±41;p=0.001) was significantly higher in patients with CD vs controls. Regarding to TGA parameters, index velocity was higher in patients than controls (163±41vs138±67nM/min;p=0.04) and in patients with fistulizing or stenosing phenotype compared to those with inflammatory phenotype. ETP was more increased in hospitalized patients vs outpatients (1515±406vs1248+380nM.min;p=0.05). High values of ETP were also associated to corticotherapy (ETP=1718.7+126.9nM*min;p=0.03). Thrombin generation was higher in patients with CRP >6mg/L vs those with normal CRP (ETP:1515+384vs1026+199nM.min;p=0.007), in those with fibrinogen level >4g/l vs those with normal fibrinogen (Peak:351±74vs295nM±64;p=0.03) and in those with elevated FVIII vs those with normal FVIII (ETP:1473.3+397vs1245+348nM.min;p=0.02). A significant positive correlation was noticed between the parameters of TGT, CRP, fibrinogen and FVIII. Thus, two biological scores correlating ETP to CRP (ETP=1384+2.9xCRP), as well as to fibrinogen (ETP=1060.7+130.5xFibrinogen).
Conclusions: Thrombin generation is more accelerated in CD patients than controls. This hypercoagulability is associated with hospitalization, stenosing and fistulizing phenotypes, corticosteroid therapy, elevated values of CRP, fibrinogen and FVIII. ETP determination from CRP and fibrinogen would be a valuable tool for assessing the state of coagulability in these patients.
To cite this abstract in AMA style:Ben Youssef H, Baccouche H, Meriem S, Aya C, Monia F, Boubaker J, Ben Romdhane N. Thrombin Generation Assay in Crohn Disease [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/thrombin-generation-assay-in-crohn-disease/. Accessed September 24, 2021.
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