Effect of Baseline Thrombocytopenia on Ischemic Outcomes in Patients With Acute Coronary Syndromes Who Undergo Percutaneous Coronary Intervention

Effect of Baseline Thrombocytopenia on Ischemic Outcomes in Patients With Acute Coronary Syndromes Who Undergo Percutaneous Coronary Intervention

Author Yadav, Mayank Google Scholar
Genereux, Philippe Google Scholar
Giustino, Gennaro Google Scholar
Madhavan, Mahesh V. Google Scholar
Brener, Sorin J. Google Scholar
Mintz, Gary Google Scholar
Caixeta, Adriano Autor UNIFESP Google Scholar
Xu, Ke Google Scholar
Mehran, Roxana Google Scholar
Stone, Gregg W. Google Scholar
Abstract Background: Acquired thrombocytopenia (TP) has been associated with short-and long-term adverse outcomes after percutaneous coronary intervention (PCI), but the role of baseline TP is less well defined. We sought to evaluate the effect of TP on long-term adverse outcomes in patients with acute coronary syndromes (ACS) who undergo PCI. Methods: Data from 10,603 patients who underwent PCI for non-ST-elevation ACS or ST-elevation myocardial infarction were pooled from 2 large-scale randomized trials, Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) and Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI). Patients were stratified according to baseline platelet counts. Those with platelet counts <150,000/mm(3) were considered to have normal platelet counts. Adverse event rates were compared between groups with and without multivariable adjustment. Results: Baseline TP was present in 607 (5.7%) patients. The unadjusted 1-year rates of death (6.7% vs 3.6%; P < 0.0001), occurrence of major adverse cardiac event (MACE) (20.8% vs 15.6%; P = 0.0002), and target lesion revascularization (TLR; 9.4% vs 7.2%; P = 0.01) were significantly higher in patients with baseline TP compared with patients with normal platelet counts. By multivariable analysis, the presence of TP at baseline was an independent predictor of 1-year death (hazard ratio [HR], 1.74; 95% confidence interval [CI], 1.12-2.69; P = 0.01), ischemic TLR (HR, 1.37; 95% CI, 1.04-1.81; P = 0.03), and MACE (HR, 1.39; 95% CI, 1.09-1.79; P = 0.009). Conclusions: The presence of baseline TP in the setting of ACS patients who undergo PCI was strongly predictive of death, ischemic TLR, and MACE at 1 year. Baseline TP might be a useful baseline clinical parameter to estimate future ischemic risk after PCI.
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Sponsor Cardiovascular Research Foundation (New York, NY)
Boston Scientific Corporation (Natick, MA)
Medicines Company (Parsippany, NJ)
Medicines Company
Nycomed (Roskilde, Denmark)
Date 2016
Published in Canadian Journal Of Cardiology. New York, v. 32, n. 2, p. 226-233, 2016.
ISSN 0828-282X (Sherpa/Romeo, impact factor)
Publisher Elsevier Science Inc
Extent 226-233
Origin https://doi.org/10.1016/j.cjca.2015.05.020
Access rights Closed access
Type Article
Web of Science ID WOS:000368602200016
URI https://repositorio.unifesp.br/handle/11600/58512

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