Characteristics and Risk Factors of Thrombotic Complications in Patients With Iron Deficiency Anemia

BACKGROUND/OBJECTIVE: Although thromboses in association with iron deficiency anemia (IDA) have been reported in several case reports, comprehensive studies investigating the incidence, characteristics, and risk factors of thrombosis in this population remain limited. Herein, we sought to characterize the clinical features of thrombosis occurring in IDA patients and to identify potential risk factors contributing to thrombosis development in this context. METHODS: This retrospective study included 329 IDA patients and 150 healthy controls. Medical records were evaluated for CBC, iron profiles, and incidence of thrombosis. Inflammatory biomarkers were calculated from baseline CBC, including ratios of neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), systemic inflammatory index (SII), systemic inflammatory response-index (SIRI), and aggregate-index of systemic inflammation (AISI). IDA patients were stratified based on thrombosis progression. RESULTS: Among IDA patients, 62 patients (18.85%) developed post-diagnosis thrombotic events (15.20% arterial and 3.65% venous), and the estimated 10-year thrombotic event-free survival rate was 73.56%. Arterial events were mostly ischemic heart diseases (n = 29, 8.81%). IDA patients with thrombotic progression showed a significant increase in NLR, MLR, PLR, SII, AISI, and SIRI compared to healthy controls. IDA patients with thrombotic progression revealed significantly higher WBC counts, neutrophils, monocytes, NLP, MLR, AISI, SIRI, older age, and a prior history of thrombosis compared to IDA patients without thrombotic events. Multivariate logistic regression analysis unveiled that age, previous history of thrombosis, and leukocytosis were independent risk factors for thrombosis progression in IDA patients. CONCLUSION: The study characterizes thrombotic events in IDA patients and underpins evidence connecting systemic inflammation to thrombosis progression, highlighting the importance of effective management of this common disorder.