Key result
Initial thrombocytopenia in ACS patients was associated with higher MACCE in-hospital (12.2% vs 2.3%, p=0.002) and at 6 months (19.3% vs 9.6%, p=0.041).
Why the study?
ACS patients with thrombocytopenia are challenging to manage because they carry high bleeding and thrombotic risks.
Does initial thrombocytopenia increase the risk of MACCE in patients with acute coronary syndromes undergoing percutaneous coronary intervention?
Cohort (n=608)
No
Does initial thrombocytopenia increase the risk of MACCE in patients with acute coronary syndromes undergoing percutaneous coronary intervention?
Absolute Event Rate: 12.2% vs 2.3%
p-value: p=0.002
Initial mild thrombocytopenia in ACS patients undergoing PCI is associated with increased short- and mid-term MACCE but not increased bleeding, suggesting standard management is appropriate.
Thrombocytopenia in ACS signals dual bleeding-thrombotic risk; leaves open optimal antithrombotic strategies pending prospective data.
Background: Acute Coronary Syndromes (ACS) patients with thrombocytopenia are challenging in their management as they carry high bleeding and thrombotic risks. Aim of Study: In this study we aimed to assess the impact of thrombocytopenia on ACS patients. Patients and Methods: We collected data of 608 ACS patients who presented to our hospital during the year 2017. Patients were divided into 2 groups according to the presence of initial thrombocytopenia: Group 1 with initial thrombocy-topenia (n=123) and group 2 without initial thrombocytopenia (n=485). Platelet count less than or equal 150.000/ml was used to define thrombocytopenia. Endpoints were in-hospital and 6 months Major Adverse Cardiovascular and Cerebrov-ascular Events (MACCE). Results: Group 1 patients were significantly older and, more likely with a history of acute coronary syndrome (38.2% versus 26.7%, p=0.049), and more likely to present as non ST elevation myocardial infarction (39% versus 26.7%, p=0.037). In hospital outcome showed significantly higher risk of cumulative MACCE in group 1 patients (12.2% versus 2.3%, p=0.002) and a similar result was found after at least 6 months follow-up (19.3% versus 9.6%, p=0.041). Both groups had similar incidence of bleeding and heart failure. Group 1 patients had significantly higher incidence of in hospital MACCE (p=0.038), but this was not significant after 6 months follow-up. Conclusions: ACS patients with mild thrombocytopenia had similar bleeding risk in comparison to patients with normal count during the hospital stay and after 6 months of follow-up, higher risk of in hospital MACCE and so they should be managed as patients with normal platelet counts.
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AYAD et al. (2021) conducted a cohort in Acute Coronary Syndromes (n=608). Initial thrombocytopenia vs. Without initial thrombocytopenia was evaluated on In-hospital Major Adverse Cardiovascular and Cerebrovascular Events (MACCE) (p=0.002). Initial thrombocytopenia in ACS patients was associated with higher MACCE in-hospital (12.2% vs 2.3%, p=0.002) and at 6 months (19.3% vs 9.6%, p=0.041).
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