Prognostic Significance of In-hospital Acquired Thrombocytopenia in Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention.
Am J Med Sci. 2019 Jul;358(1):19-25
Authors: Jiang P, Gao Z, Zhao W, Song Y, Tang X, Xu J, Wang H, Jiang L, Chen J, Qiao S, Yang Y, Gao R, Xu B, Yuan J
BACKGROUND: This large cohort study aimed to investigate the effect of acquired thrombocytopenia on the prognosis of patients with stable coronary artery disease undergoing percutaneous coronary intervention (PCI).
MATERIALS AND METHODS: Patients with stable coronary artery disease undergoing elective PCI were prospectively enrolled during 2013. All patients were followed for a median of 30 months (the 25th and 75th percentiles for follow-up time were 27 and 32 months). After excluding patients with baseline thrombocytopenia (<150 × 109/L), in-hospital acquired thrombocytopenia was defined as lowest platelet count <150 × 109/L or a relative reduction of 50% from the preoperative baseline platelet count after PCI.
RESULTS: A total of 3,614 patients were enrolled; 329 (7.8%) patients developed thrombocytopenia after PCI. Analyses showed no difference in adverse events between groups during hospitalization, while long-term all-cause mortality, minor bleeding and major bleeding were significantly higher in patients with thrombocytopenia than in the control group. After multivariable adjustment, thrombocytopenia remained an independent risk factor for long-term all-cause mortality (HR 2.782, 95% CI 1.182-6.552, P = 0.019), minor bleeding (HR 2.198, 95% CI 1.217-3.972, P = 0.009) and major bleeding (HR 5.409, 95% CI 1.541-8.999, P = 0.008). Predictors of acquired thrombocytopenia were age, body mass index, baseline platelet count and left ventricular ejection fraction.
CONCLUSIONS: Acquired thrombocytopenia may predict long-term all-cause mortality and bleeding events in patients with stable coronary artery disease who receive elective PCI.
PMID: 31228966 [PubMed - in process]