Abstract
Various indices have been used to assess Crohn's disease (CD). However, the question of whether the Crohn's Disease Activity Index (CDAI) is associated with coagulation function has not been fully confirmed. In this study, we examined the association between CDAI and the coagulation and fibrinolysis parameters. In a retrospective and observational cohort study, the CDAI of 108 patients from two hospital centers was calculated, and its correlations with the prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), international normalization ratio (INR), fibrinogen (Fg) and plasma D-Dimer were investigated. Significant differences were found for PT, APTT, TT, INR, Fg and D-Dimer between the healthy controls and CD patients. However, no significant difference was found between the CDAI-High and CDAI-Low groups of CD patients. Moreover, the CDAI was positively correlated with the level of D-Dimer in CD patients of two hospitals, regardless of the detection method (hospital 1: r=0.3268, p= 0.0042; hospital 2: r=0.5553, p=0.0008). Among the blood coagulation and fibrinolysis parameters, the D-Dimer level was highly correlated with CDAI in CD patients. Thus, the level of D-Dimer expression may be a promising new marker for assessing CD disease activity.
Highlights
Inflammatory bowel disease (IBD) is a chronic, relapsing, and inflammatory disorder of the gastrointestinal tract that includes two conditions: Crohn’s disease (CD) and ulcerative colitis (UC)
We examined the association between Crohn’s Disease Activity Index (CDAI) and the coagulation and fibrinolysis parameters
Our results show that there was no difference for the prothrombin time (PT) (r =-0.0164, p =0.8662), thrombin time (TT) (r =-0.0156, p =0.8727), activated partial thromboplastin time (APTT) (r =-0.1146, p =0.2374), international normalization ratio (INR) (r =0.0831, p =0.3923), or Fg (r =0.1665, p =0.0851) but that the levels of plasma D-Dimer are significantly correlated with the CDAI (r =0.3562, p =0.0002) (Table 4)
Summary
Inflammatory bowel disease (IBD) is a chronic, relapsing, and inflammatory disorder of the gastrointestinal tract that includes two conditions: Crohn’s disease (CD) and ulcerative colitis (UC). It is well recognized that CD is associated with an increased risk for the development of a number of extra-intestinal manifestations, which include skin, joint and eye manifestations [1, 2]. Acquired endothelial dysfunction, coagulation system activation, impaired fibrinolysis and platelet abnormalities are the main characteristics of the hypercoagulable status of CD patients [4]. This hypercoagulable state is followed by an increased risk of venous thromboembolism (VTE) which is associated with the disease activity [4]. Thromboprophylaxis is strongly recommended for the clinical management of CD patients, especially hospitalized patients [4, 5]
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