Author |
Yadav, Mayank
![]() Genereux, Philippe ![]() Giustino, Gennaro ![]() Madhavan, Mahesh V. ![]() Brener, Sorin J. ![]() Mintz, Gary ![]() Caixeta, Adriano ![]() ![]() Xu, Ke ![]() Mehran, Roxana ![]() Stone, Gregg W. ![]() |
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 |
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Access rights | Closed access |
Type | Article |
Web of Science ID | WOS:000368602200016 |
URI | https://repositorio.unifesp.br/handle/11600/58647 |
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