Association of carotid intima media thickness with cardiovascular disease risk in immune thrombocytopenia.

PURPOSE: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by reduced platelet count, associated with both an increased bleeding tendency and a paradoxically elevated risk of thrombotic events. Recent evidence suggests paradoxical thrombotic risk in ITP, raising concerns about cardiovascular disease (CVD). We evaluated the role of carotid intima-media thickness (CIMT) as a marker to predict cardiovascular risk in ITP. METHODS: A cross-sectional study of 100 adult patients with ITP was conducted at Beni Suef University Hospital. The mean CIMT (mCIMT) was measured by carotid ultrasonography. CVD risk was assessed using the total cholesterol/high-density lipoprotein ratio (TCHOL/HDL). Statistical analysis included logistic regression, propensity score matching, and partial least squares regression. RESULTS: Eighteen percent of patients were classified as having high risk CVD. The median mCIMT was 0.575 mm overall, but significantly higher in high-risk patients (0.72 vs. 0.55 mm). mCIMT > 0.575 mm was independently associated with nearly 11-fold higher odds of increased CVD risk per the TCHOL/HDL ratio. Platelet count, platelet distribution width, and treatment line were not associated with CVD risk. CONCLUSION: Carotid intima-media thickening is significantly associated with CVD risk in ITP and may serve as a non-invasive surrogate marker for early detection of atherosclerotic burden.