Abstract
Objective
To assess early and late outcomes, including bleeding, in patients with thrombocytopenia
undergoing percutaneous coronary intervention (PCI).
Patients and Methods
We performed a retrospective single-center study of patients with preprocedural thrombocytopenia
(platelet count ≤100,000/μL; n=204) undergoing PCI between 2003 and 2015. Inhospital
and late outcomes were compared with those of a matched control group without thrombocytopenia
(n=1281).
Results
The most common causes of thrombocytopenia were liver disease, immune-mediated disease,
and hematologic malignant neoplasms. Inhospital bleeding events after PCI were similar
in patients with thrombocytopenia and matched controls (24 of 146 [16.4%] vs 179 of
1281 [14.0%]; P=.40) and were largely classified as minor using the Bleeding Academic Research Consortium
(BARC) classification (89% BARC 1 or 2). There was no significant difference in inhospital
death (4 of 146 [2.7%] vs 71 of 1281 [2.0%]; P=.56), but patients with thrombocytopenia had higher rates of platelet and red blood
cell transfusion (18 of 146 [12.3%] vs 93 of 1281 [7.2%]; P=.05). During long-term follow-up, Kaplan-Meier estimated rates of bleeding events
(BARC ≥2) were higher for thrombocytopenia (at 5 years, 7.9% vs 3.6%; P=.03). Patients with thrombocytopenia had a similar risk of long-term cardiac mortality,
but significantly higher rates of noncardiac mortality (at 5 years, 28% vs 21%; P=.02).
Conclusion
This study suggests that short-term outcomes after PCI in patients with thrombocytopenia
were favorable. On long-term follow-up, thrombocytopenia was associated with a higher
risk of long-term noncardiac mortality and bleeding.
Abbreviations and Acronyms:
BARC (Bleeding Academic Research Consortium), CABG (coronary artery bypass graft), DES (drug-eluting stent), Gp (glycoprotein), INR (international normalized ratio), MI (myocardial infarction), PCI (percutaneous coronary intervention)To read this article in full you will need to make a payment
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Article Info
Footnotes
Grant Support: Dr Raphael was supported by the British Heart Foundation.
Identification
Copyright
© 2016 Mayo Foundation for Medical Education and Research
