Ischemic and Bleeding Events Associated with Thrombocytopenia and Thrombocytosis after Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

Authors

Ji Woong Roh, The Catholic University of Korea
Sungmin Lim, The Catholic University of Korea
Youngdeok Hwang, CUNY Bernard M Baruch CollegeFollow
Kwan Yong Lee, The Catholic University of Korea
Eun Ho Choo, The Catholic University of Korea
Ik Jun Choi, The Catholic University of Korea
Byung-Lee Hwang, The Catholic University of Korea
Chan Joon Kim, The Catholic University of Korea
Mahn-Won Park, The Catholic University of Korea
Dong-Bin Kim, The Catholic University of Korea
Jong-Min Lee, The Catholic University of Korea
Chul Soo Park, The Catholic University of Korea
Hee-Yeol Kim, The Catholic University of Korea
Ki-Dong Yoo, The Catholic University of Korea
Doo Soo Jeon, The Catholic University of Korea
Ho Joong Youn, The Catholic University of Korea
Wook Sung Chung, The Catholic University of Korea
Min Chul Kim, Chonnam National University
Myung Ho Jeong, Chonnam National University
Youngkeun Ahn, Chonnam National University
Kiyuk Chang, The Catholic University of Korea

Document Type

Article

Publication Date

10-21-2020

Abstract

The early and late ischemic and bleeding clinical outcomes according to baseline platelet count after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) remain unclear. Overall, 10,667 patients from the Cardiovascular Risk and identification of potential high-risk population in AMI (COREA-AMI) I and II registries were classified according to the following universal criteria on baseline platelet counts: (1) moderate to severe thrombocytopenia (platelet < 100 K/µL, n = 101), (2) mild thrombocytopenia (platelet = 100~149 K/µL, n = 631), (3) normal reference (platelet = 150~450 K/µL, n = 9832), and (4) thrombocytosis (platelet > 450 K/µL, n = 103). The primary endpoint was the occurrence of major adverse cardiovascular events (MACE). The secondary outcome was Bleeding Academic Research Consortium (BARC) 2, 3, and 5 bleeding. After adjusting for confounders, the moderate to severe thrombocytopenia (HR, 2.03; 95% CI, 1.49–2.78); p < 0.001), mild thrombocytopenia (HR, 1.15; 95% CI, 1.01–1.34; p = 0.045), and thrombocytosis groups (HR, 1.47; 95% CI, 1.07–2.03; p = 0.019) showed higher 5-year MACE rates than the normal reference. In BARC 2, 3, and 5 bleeding outcomes, the bleedings rates were higher than the normal range in the moderate to severe thrombocytopenia (HR, 2.18; 95% CI, 1.36–3.49; p = 0.001) and mild thrombocytopenia (HR, 1.41; 95% CI, 1.12–1.78; p = 0.004) groups. Patients with AMI had higher 5-year MACE rates after PCI if they had lower- or higher-than-normal platelet counts. Thrombocytopenia revealed higher early and late bleeding rates whereas thrombocytosis showed long-term bleeding trends, although these trends were not statistically significant.

Comments

This article was originally published in the Journal of Clinical Medicine, available at https://doi.org/10.3390/jcm9103370.

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).