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Peric S, Todorovic Z, Zdravkovic N, Gogic A, Simovic S, Grbovic V, Maksic M, Jakovljevic S, Milovanovic O, Zdravkovic N. Treatment of Ulcerative Colitis: Impact on Platelet Aggregation. Medicina (Kaunas) 2023; 59:1615. [PMID: 37763734 PMCID: PMC10534470 DOI: 10.3390/medicina59091615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/14/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Ulcerative colitis is chronic and/or progressive inflammation of the colorectal mucosa and submucosa and represents one of two major inflammatory bowel diseases. Ulcerative colitis has been associated with increased risk of arteriosus and venous thrombosis. There are numerous factors responsible for this; one of them is platelet activation and aggregation. The objective of our study was to determine if different treatment options for ulcerative colitis have an impact on platelet aggregation. Materials and Methods: This research was a prospective, observational study and included 94 newly diagnosed patients with UC divided into four treatment groups. For all patients, we measured platelet aggregability by using an impedance aggregometry method with a multiplate analyzer before and after treatment with infliximab, adalimumab, vedolizumab and azathioprine. A Paired Samples t test was performed in order to determine the difference in platelet aggregability before and after a certain therapy, since the data followed a normal distribution. Taking into account the impact of some clinical characteristics, multiple linear regression was conducted for the purpose of estimating the effect of therapy on the level of reduction in platelet aggregability. Results: All four drugs significantly reduced platelet aggregability. After we excluded the influence of clinical and endoscopic scores and disease localization on the results, we found that infliximab had the greatest anti-platelet activity. Conclusions: In addition to the well-known traditional risk factors for atherosclerosis, activation and aggregation of platelets play a significant role in the development of arterial thrombosis, and our results suggested that therapy use for the treatment of UC, especially infliximab, can have a great impact on cardiovascular morbidity and mortality by decreasing platelet aggregability.
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Affiliation(s)
- Sasa Peric
- Clinic of Gastroenterology and Hepatology, Military Medical Academy, Crnotravska Street 17, 11000 Belgrade, Serbia;
| | - Zeljko Todorovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia; (S.S.); (M.M.); (N.Z.)
- Clinic for Hematology, University Clinical Center Kragujevac, Zmaj Jovina Street 30, 34000 Kragujevac, Serbia
| | - Nebojsa Zdravkovic
- Department of Medical Statistics and Informatics, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia; (N.Z.); (A.G.)
| | - Andjela Gogic
- Department of Medical Statistics and Informatics, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia; (N.Z.); (A.G.)
| | - Stefan Simovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia; (S.S.); (M.M.); (N.Z.)
- Clinic for Cardiology, University Clinical Center Kragujevac, Zmaj Jovina Street 30, 34000 Kragujevac, Serbia
| | - Vesna Grbovic
- Department of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia;
- Center for Physical Medicine and Rehabilitation, University Clinical Center Kragujevac, Zmaj Jovina Street 30, 34000 Kragujevac, Serbia
| | - Mladen Maksic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia; (S.S.); (M.M.); (N.Z.)
- Clinic of Gastroenterology and Hepatology, University Clinical Center Kragujevac, Zmaj Jovina Street 30, 34000 Kragujevac, Serbia
| | - Stefan Jakovljevic
- Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia;
- Clinic for Surgery, University Clinical Center Kragujevac, Zmaj Jovina Street 30, 34000 Kragujevac, Serbia
| | - Olivera Milovanovic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia;
| | - Natasa Zdravkovic
- Department of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, Svetozar Markovic Street 69, 34000 Kragujevac, Serbia; (S.S.); (M.M.); (N.Z.)
- Clinic of Gastroenterology and Hepatology, University Clinical Center Kragujevac, Zmaj Jovina Street 30, 34000 Kragujevac, Serbia
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