Effect of Preprocedural Thrombocytopenia on Prognosis After Percutaneous Coronary Intervention

Claire E. Raphael, Daniel B. Spoon, Malcolm R. Bell, Peter J. Psaltis, Stephen Kidd, Shu X. Loh, Ryan J. Lennon, Mandeep Singh, Charanjit Rihal, Rajiv Gulati

Research output: Contribution to journalArticle

17 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1035-1044
Number of pages10
JournalMayo Clinic Proceedings
Volume91
Issue number8
DOIs
StatePublished - Aug 1 2016

ASJC Scopus subject areas

  • Medicine(all)

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