Highlights
- •The prevalence of older patients with acquired TTP is increasing.
- •There is scarce information on acquired TTP in the elderly.
- •Older TTP patients had a higher prevalence of multimorbidity and polypharmacy.
- •A careful comprehensive geriatric assessment of older TTP patients is necessary.
Abstract
Background
The prevalence of older patients with acquired thrombotic thrombocytopenic purpura
(TTP) is increasing. There is scarce information on the prevalence of multimorbidity,
polypharmacy and age-related diseases in aging TTP patients. This study aimed to evaluate
the prevalence of multimorbidity and polypharmacy in a population of acquired TTP
patients aged 65 years or more compared with a group of age-matched controls.
Methods
Acquired TTP patients enrolled in the Milan TTP registry from December 1st 1999 to
March 31th 2018 and aged 65 years or more at the date of last follow-up were evaluated.
Controls were Italian healthy individuals recruited from 2006 to March 31th 2018 among
friends and non-consanguineous relatives of patients tested for thrombophilia screening
at the Angelo Bianchi Bonomi Hemophilia and Thrombosis Center of Milan.
Results
36 TTP patients and 127 age-matched controls were included. Compared with controls,
TTP patients had a higher prevalence of multimorbidity and polypharmacy. They also
showed a higher prevalence of autoimmune diseases, osteoporosis and arterial hypertension
and were more chronically treated with corticosteroids and antiplatelets for primary
cardiovascular prevention. All these results were confirmed after adjusting for sex.
Compared with the general elderly population, TTP patients showed a higher prevalence
of ischemic heart disease and stroke.
Conclusions
Our findings suggest that a careful comprehensive geriatric assessment of acquired
TTP patients is necessary. It is important to look for other autoimmune diseases and
such age-related comorbidities as osteoporosis, arterial hypertension, ischemic heart
disease and cerebrovascular disease.
Keywords
Abbreviations:
TTP (thrombotic thrombocytopenic purpura), IQR (interquartile range), CI (confidence interval)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 19, 2020
Accepted:
January 29,
2020
Received in revised form:
January 27,
2020
Received:
November 6,
2019
Footnotes
A complete list of the members of the Italian Group of TTP Investigators appears in the “Study Group Members” in the Supplementary file.
Identification
Copyright
© 2020 Published by Elsevier B.V. on behalf of European Federation of Internal Medicine.
