A 10% greater reduction in platelet count during intra-aortic balloon pumping was associated with a significantly increased risk of cardiovascular mortality after device removal (HR 1.3).
Observational (n=439)
Sí
Does a higher percent reduction in platelets during IABP counterpulsation predict higher cardiovascular mortality after device removal in acutely critical patients?
A greater reduction in platelet count during IABP counterpulsation independently predicts an increased risk of cardiovascular mortality after device removal, potentially linked to systemic inflammation.
Estimación del efecto: HR 1.3 (95% CI 1.1-1.6)
valor p: p=<0.001
Thrombocytopenia is a frequent complication in patients requiring intra-aortic balloon pumping (IABP) counterpulsation. However, its prognostic impact has not been fully addressed. The objective of this study is to evaluate the impact of the change in the platelet number during IABP use on the prognosis after device removal.This is a retrospective observational study. Patients in the intensive cardiac care unit at three Juntendo University hospitals who underwent percutaneous implantation of IABP with or without veno-arterial extracorporeal membrane oxygenation (V-A ECMO), since 2012-2016, were enrolled in the study (n = 439). Patients who died during mechanical circulatory support (n = 47) were excluded. We evaluated the prognostic impact of the ratio of platelet reduction from the baseline (% PLT reduction) during IABP use on cardiovascular mortality after device removal.The median and the range of follow-up period were 298 days and 0-1,869 days, respectively. Unadjusted Kaplan-Meier analysis demonstrated that patients with a higher % PLT reduction had higher cardiovascular (CV) mortality. An adjusted Cox proportional hazard analysis demonstrated that a 10% higher % PLT reduction was associated with higher cardiovascular (CV) mortality (Hazard ratio: 1.3, 95% Confidence interval: 1.1-1.6, P < 0.001). Moreover, % PLT reduction and the maximum C-reactive protein (CRP) level during IABP use were positively correlated (r = 0.326, P < 0.001).The reduced number of platelets during IABP use was associated with an increased risk of CV mortality.
Takano et al. (Thu,) conducted a observational in Hemodynamically unstable patients requiring intra-aortic balloon pumping (IABP) (n=439). 10% higher percent platelet reduction during IABP was evaluated on Cardiovascular mortality after device removal (HR 1.3, 95% CI 1.1-1.6, p=<0.001). A 10% greater reduction in platelet count during intra-aortic balloon pumping was associated with a significantly increased risk of cardiovascular mortality after device removal (HR 1.3).