PB0403 - Prevalence and risk factors for thromboembolism in outpatients with inflammatory bowel disease.

Background: Patients affected by inflammatory bowel diseases (IBD), namely Crohn’s disease (CD) and ulcerative colitis (UC) are at risk for thrombotic events (TE). Patients with active/relapsing disease or needing steroids, hospitalization, surgery, show the highest risk. On the contrary, the risk in the IBD out-patients is underestimated/poorly investigated.

Aims: To evaluate the prevalence/features of TE in out-patients with IBD.

Methods: From May 2019 to September 2022, consecutive IBD out-patients were evaluated for the presence of common risk factors (smoking, hypertension, diabetes, dyslipidaemia, oral contraceptives) and those with a history of TE (arterial thrombosis, heart attack, ischaemic stroke/TIA, deep vein thrombosis/superficial vein thrombosis, pulmonary embolism) were studied for thrombophilia (antithrombin, protein C, Protein S, anticardiolipin antibodies -aCL-, LA, MTHF C677T, FV Leiden, FII G20210A).

Results: 303 IBD patients were enrolled (153 CD; 150 UC; mean age: 41 years). Twenty-three IBD patients (7.5%) showed a TE event. We observed 14 UC patients with TE (9.3%), 9 CD patients with TE (5.8%). About the specific type of TE, we recorded: 5 arterial thromboses, 3 heart attacks, 1 stroke, 3 TIA, 8 deep vein thromboses (in 2 cases with pulmonary embolism), 3 superficial vein thromboses. When considering the risk factors, 60 patients were smokers, 66 patients were ex-smoker; 70 patients showed hypertension, 26 were obese, 16 patients showed dyslipidaemia, 8 patients assumed estro-progestogens. At the univariate analysis, hypertension (p < 0.01; OR 5.1), obesity (p < 0.01; OR 4.6) and dyslipidaemia (p < 0.01; OR 4.7) were significantly correlated to TE, with no differences between CD and UC. When considering the thrombophilia, 2 patients showed homozygosity for MTHF C677T, 1 patient FV Leiden heterozygosity. No significant alterations were found for aCL/LA.

Conclusion(s): Out-patients with IBD presented a not negligible risk of TE, mainly correlated to the common risk factors described in general population. Clinicians should not underestimate TE risk in these patients.