Study links older age, heart issues to higher risk of blood clots in ITP
Researchers urge management of metabolic and vascular risk factors
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Even though immune thrombocytopenia (ITP) is a bleeding disorder, people with the disease can paradoxically experience thrombosis — abnormal clots that block blood flow, which can be dangerous and even life-threatening in some cases.
In a new study, researchers in China reported that ITP patients at their center had higher rates of thrombosis than what’s been reported among ITP patients in other parts of the world. The findings indicate that the risk of thrombosis is highest among people with ITP who are older and/or have other cardiovascular risk factors, such as high blood pressure.
The study, “Cardiovascular and comorbid risk factors for thrombosis in primary immune thrombocytopenia:A single-center retrospective study,” was published in Research and Practice in Thrombosis and Haemostasis.Â
Thrombosis rates notably higher than in previous studies
ITP is a disorder in which the immune system mistakenly attacks and destroys platelets, which are cell fragments that normally help blood clot. Low platelet levels, known medically as thrombocytopenia, can lead to symptoms such as abnormal bleeding and bruising.
Even though ITP is a bleeding disorder, people with the disease can experience thrombosis. There are two main types of thrombosis: arterial thrombosis, which affects arteries (vessels that carry oxygen-rich blood from the heart out to the body’s tissues), and veneous thrombosis, which affects veins (vessels that carry oxygen-depleted blood back to the heart).
Previous studies from the U.S. and Europe have estimated that the rate of arterial thrombosis in ITP is about one to three events per 100 person-years. For venous thrombosis, previous studies have estimated the rate in ITP at slightly less than one per 100 person-years. (One person-year means one person followed for one year.)
In this study, scientists in China reported rates of thrombosis among 764 adults with ITP who received care at their center between 2014 and 2025. Most of these patients were followed for four years or more, with a total of more than 3,500 person-years of follow-up.
Results showed that the overall rate of arterial thrombosis was 5.7 per 100 person-years, while the rate for venous thrombosis was 2.1 per 100 person-years. These rates are notably higher than what’s been reported in studies from other parts of the world. These differences “may be attributed to differences in population characteristics,” the researchers said, noting that differences in rates of co-occurring conditions and cardiovascular risk factors may contribute.
Thrombosis risk elevated in patients with co-occurring health problems
The researchers also conducted statistical analyses looking for factors that were associated with thrombosis risk among their ITP patients. Results showed that age was a powerful risk factor for both arterial and venous thrombosis: the risk of dangerous clots was elevated in older adults, with the highest risk among those ages 75 or older. This finding is in agreement with studies in Western populations, which have similarly identified older age as a key risk factor for thrombosis in ITP.
The risk of thrombosis was also elevated in patients with co-occurring health problems, most notably chronic kidney disease. Established cardiovascular risk factors like high blood pressure, high blood sugar, and high blood fat levels were also associated with an increased risk of thrombosis. This suggests that it may be possible to reduce thrombosis risk in ITP patients by managing co-occurring health issues, the researchers said.
“Adequate management of these metabolic and vascular risk factors could substantially reduce the risk of [arterial thrombosis],” the researchers wrote.
Results also showed that the risk of thrombosis was significantly elevated among ITP patients who had received ITP treatments within the prior three months. These findings underscore the importance of carefully balancing ITP control against thrombosis risk, and managing treatment accordingly.
[The finding] underscores the importance of routine evaluation and actively managing comorbid [coexisting] conditions in all diagnosed ITP individuals to mitigate subsequent thrombotic risk.
Notably, platelet counts were not significantly associated with thrombosis risk.
The researchers further noted that their finding “underscores the importance of routine evaluation and actively managing comorbid [coexisting] conditions in all diagnosed ITP individuals to mitigate subsequent thrombotic risk.”
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