The impact of acquired thrombocytopenia on long-term outcomes of patients undergoing elective percutaneous coronary intervention: An analysis of 8,271 consecutive patients.

BACKGROUND

Acquired thrombocytopenia is associated with an increased risk of adverse events of patients with acute coronary syndrome. However, data on its long-term prognostic significance are limited. The aim of our study was to investigate the association between acquired thrombocytopenia and long-term clinical outcomes.

METHODS

We examined 8,271 consecutive patients who underwent elective percutaneous coronary intervention (PCI) at Fuwai Hospital from January 2013 to December 2013. Acquired thrombocytopenia was defined as a platelet count of <150 × 10 /L after PCI with a normal baseline value. The primary outcomes were death and major adverse cardiovascular events (MACEs) during a 30-month follow-up. Logistic regression was performed to identify independent predictors of acquired thrombocytopenia post-PCI.

RESULTS

At the 30-month follow-up, acquired thrombocytopenia developed in 654 (7.91%) patients (634 [7.67%] patients had mild thrombocytopenia, 20 [0.24%] patients had moderate or severe thrombocytopenia). Patients who developed thrombocytopenia had a higher 30-month rate of all-cause death (2.3% vs. 1%, P = 0.0086) and cardiogenic death (1.2% vs. 0.5%, P = 0.0261) than patients who did not develop thrombocytopenia. Moderate or severe thrombocytopenia was associated with a 13-fold increased risk for cardiogenic death (adjusted HR: 13.578; 95% CI: 1.812-101.75) and 11-fold increased risk for myocardial infarction (adjusted HR: 11.309; 95% CI: 2.749-46.53) compared with patients without thrombocytopenia. Baseline creatinine clearance (odds ratio [OR]: 0.993; 95% CI: 0.989-0.996), baseline platelet count (OR: 0.924; 95% CI: 0.918-0.93) and diabetes mellitus history (OR: 1.283, 95% CI: 1.056-1.558) independently predicted acquired thrombocytopenia.

CONCLUSIONS

Acquired thrombocytopenia was independently associated with long-term adverse outcomes. Predictors of thrombocytopenia were baseline creatinine clearance, baseline platelet count, and diabetes mellitus history.