Idiopathic Thrombocytopenic Purpura and Cardiovascular Disease: Is Elevated Triglycerides to High-density Lipoprotein Cholesterol Ratio a Marker?

Introduction:Triglycerides to high-density lipoprotein cholesterol (TG/HDL-C) ratio is used as a cardiovascular risk marker. We aimed to investigate the relationship between TG/HDL ratio and eltrombopag use, current platelet values and whether or not splenectomy was performed in patients with chronic idiopathic thrombocytopenic purpura (ITP), and to emphasize its prognostic importance in terms of cardiovascular markers.Methods:One hundred and thirty-nine chronic ITP patients followed in the hematology outpatient clinic were evaluated retrospectively. We investigated the negative effect of splenectomy, eltrombopag use and current platelet values on cardiovascular diseases. Patients were stratified into two groups according to their baseline TG/HDL-C ratio, using a TG/HDL-C ratio cut-off value of 2.5.Results:A total number of 139 chronic ITP patients aged between 18-76 years, followed-up in the hematology outpatient clinic, were included in the study; and 102 of the patients were female (75%). The mean platelet value was 2913.24±103353.64/mm3, and the mean TG/HDL-C ratio was 2.91±2.09. There were 46 (33.8%) patients who had splenectomy. When patients were evaluated in terms of treatment modalities; 127 patients (93.4%), 60 patients (44.1%), and 19 (13.9%) patients were using methyl prednisolone, intravenous immunoglobulin, and eltrombopag, respectively. It was observed that the parameters were similar in patients using and not using eltrombopag (p>0.05). There was a weak and statistically significant correlation between TG/HDL-C values and age (r=0.275; p=0.001). There was a significant correlation between the presence of DM and hyperlipidemia and the TG/HDL-C ratio (p<0.05). In risk assessment, the TG/HDL-C ratio of individuals without coronary artery disease was 2.29 (1.47 3.38) and it was found to be statistically significantly low (p=0.025).Conclusion:TG/HDL-C ratio can be used as an independent risk marker that can be diagnostic in predicting cardiovascular disease risk in ITP patients with advanced age and additional comorbid diseases (DM and hyperlipidemia).