Cheng Wan-Jun, Yang Shi-Wei, Gao Fei, Guo Yong-He, Wang Zhi-Jian, Zhou Yu-Jie
Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing, China.
J Geriatr Cardiol. 2018 May;15(5):346-355. doi: 10.11909/j.issn.1671-5411.2018.05.004.
The aim is to evaluate the association between baseline platelet count (PC) and severe adverse outcomes following percutaneous coronary intervention (PCI) in current real-world practice.
A total of 18,788 patients underwent PCI with drug-eluting stents constituted the study population. Patients were categorized as having low (< 150 × 1000/µL), normal (150-300 × 1000/µL), and high (≥ 300 × 1000/µL) baseline PC. The primary endpoints included in-hospital and follow-up all-cause mortality. The secondary endpoint was major bleeding requiring a blood transfusion.
In-hospital mortality rates for patients with low, normal, and high baseline PC were 0.6%, 0.4%, and 0.4%, respectively ( = 0.259). Similarly, mortality rates during long-term follow-up (median 23.8 months) for patients with low, normal, and high baseline PC were 0.9%, 0.6%, and 0.7%, respectively ( = 0.079). After multivariate adjustment, patients with low or high baseline PC tended to have similar risks for both in-hospital and follow-up mortality compared with the normal group. Subgroup analyses failed to demonstrate an independent prognostic value of baseline PC in specific population groups except patients who undwent transfemoral PCI. There was also no significant difference in the incidence of major bleeding requiring a blood transfusion in the low, normal, and high groups (0.5%, 0.3%, and 0.3%, respectively; = 0.320). After multivariate adjustment, low or high baseline PC did not significantly increase the risk of major bleeding.
There is no significant association between baseline PC and severe adverse outcomes following PCI in current real-world practice.
旨在评估在当前实际临床实践中,经皮冠状动脉介入治疗(PCI)后基线血小板计数(PC)与严重不良结局之间的关联。
共有18788例行药物洗脱支架PCI的患者构成研究人群。患者被分为基线PC低(<150×1000/μL)、正常(150 - 300×1000/μL)和高(≥300×1000/μL)三组。主要终点包括住院期间及随访期的全因死亡率。次要终点为需要输血的大出血。
基线PC低、正常和高的患者住院死亡率分别为0.6%、0.4%和0.4%(P = 0.259)。同样,基线PC低、正常和高的患者在长期随访(中位时间23.8个月)期间的死亡率分别为0.9%、0.6%和0.7%(P = 0.079)。多因素调整后,与正常组相比,基线PC低或高的患者在住院及随访死亡率方面的风险趋于相似。亚组分析未显示除经股动脉PCI患者外,基线PC在特定人群组中有独立的预后价值。低、正常和高组中需要输血的大出血发生率也无显著差异(分别为0.5%、0.3%和0.3%;P = 0.3