Impact of Acquired Thrombocytopenia on Cardiovascular Outcomes in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis

被引:0
作者
Ahsan, Muhammad Junaid [1 ]
Fazeel, Hafiz Muhammad [2 ]
Ul Haque, Syed Mansur [1 ]
Malik, Saad Ullah [3 ]
Latif, Azka [1 ]
Lateef, Noman [1 ]
Batool, Syeda Sabeeka [4 ]
Kousa, Omar [1 ]
Ahsan, Mohammad Zoraiz [5 ]
Anwer, Faiz [6 ]
Andukuri, Venkata [1 ]
Smer, Aiman [7 ]
机构
[1] Creighton Univ, Dept Internal Med, Med Ctr, 7500 Mercy Rd, Omaha, NE 68124 USA
[2] Serv Inst Med Sci, Dept Internal Med, Lahore, Pakistan
[3] Marshall Univ, Dept Internal Med, Huntington, WV USA
[4] Univ Alabama, Dept Internal Med, Huntsville, AL 35899 USA
[5] Fatima Mem Hosp, Dept Internal Med, Lahore, Pakistan
[6] Cleveland Clin, Dept Hematol Oncol, Cleveland, OH 44106 USA
[7] Creighton Univ, Med Ctr, Div Cardiovasc Med, Omaha, NE 68124 USA
关键词
Acquired thrombocytopenia; Coronary artery disease; Percutaneous coronary intervention; ASSOCIATION; HEPARIN; ANGIOPLASTY; ABCIXIMAB;
D O I
10.1016/j.carrev.2020.07.014
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Acquired thrombocytopenia (aTP) is associated with a high frequency of bleeding and ischemic complications in patients undergoing percutaneous coronary intervention (PCI). Herein, we report a metaanalysis evaluating the adverse effects of aTP on cardiovascular outcomes and mortality post-PCI. Methods: A literature search was performed using PubMed, Embase, Cochrane and, clinicaltrials.gov from the inception of these databases through October 2019. Patients were divided into two groups: 1) No Thrombocytopenia (nTP) and 2) Acquired Thrombocytopenia (aTP) after PCI. Primary endpoints were in-hospital, 30-day and all-cause mortality rates at the longest follow-up. The main summary estimate was random effects Risk ratio (RR) with 95% confidence intervals (CIs). Results: Seven studies involving 57,247 participants were included. There was significantly increased in-hospital all-cause mortality (HR 10.73 [6.82-16.88]), MACE (HR 2.9612.24-3.941). major bleeding (HR 4.7813.54-6.47]), and target vessel revascularization (TVR) (HR 7.53 [2.8-20.2]), in the aTP group compared to the nTP group. Similarly, all) group had a statistically significant increased incidence of 30-day all-cause mortality (HR 6.08), MACE (HR 2.77), post-PG MI (HR 1.98), TVR (HR 52), and major bleeding (HR 12.73). Outcomes at longest follow-up showed increased incidence of all-cause mortality (HR 3.98 [1.53-10.33]) and MACE (HR 124 [0.99-1.54]) in aTP group, while there was no significant difference for post-PCI MI (HR 0.94 10.37-2.391) and TVR (HR 0.96 [0.69-1.32]) between both groups. Conclusions: Acquired Thrombocytopenia after PCI is associated with increased morbidity, mortality, adverse bleeding events and the need for in-hospital and 30-day TVR. (C) 2020 Elsevier Inc. All rights reserved.
引用
收藏
页码:79 / 87
页数:9
相关论文
共 29 条
[1]   Effects of baseline and early acquired thrombocytopaenia on long-term mortality in patients undergoing percutaneous coronary intervention with bivalirudin [J].
Ali, Ziad A. ;
Qureshi, Yasir H. ;
Galougahi, Keyvan Karimi ;
Poludasu, Shyam ;
Roy, Swathi ;
Krishnan, Prakash ;
Zalewski, Adrian ;
Shah, Zainab Z. ;
Bhatti, Navdeep ;
Kalapatapu, Kumar ;
Mehran, Roxana ;
Dangas, George ;
Kini, Annapoorna S. ;
Sharma, Samin K. .
EUROINTERVENTION, 2016, 11 (14) :E1627-E1638
[2]  
[Anonymous], 2014, QUALITY ASSESSMENT T
[3]   HEPARIN-ASSOCIATED THROMBOCYTOPENIA - A COMPARISON OF 3 HEPARIN PREPARATIONS [J].
BELL, WR ;
ROYALL, RM .
NEW ENGLAND JOURNAL OF MEDICINE, 1980, 303 (16) :902-907
[4]   Incidence and clinical consequences of acquired thrombocytopenia after antithrombotic therapies in patients with acute coronary syndromes: Results from the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial [J].
Caixeta, Adriano ;
Dangas, George D. ;
Mehran, Roxana ;
Feit, Frederick ;
Nikolsky, Eugenia ;
Lansky, Alexandra J. ;
Aoki, Jiro ;
Moses, Jeffrey W. ;
Steinhubl, Steven R. ;
White, Harvey D. ;
Ohman, E. Magnus ;
Manoukian, Steven V. ;
Fahy, Martin ;
Stone, Gregg W. .
AMERICAN HEART JOURNAL, 2011, 161 (02) :298-U450
[5]   Incidence, Predictors, and Outcomes of Acquired Thrombocytopenia After Percutaneous Coronary Intervention A Pooled, Patient-Level Analysis of the CHAMPION Trials (Cangrelor Versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition) [J].
Groves, Elliott M. ;
Bhatt, Deepak L. ;
Steg, Philippe Gabriel ;
Deliargyris, Efthymios N. ;
Stone, Gregg W. ;
Gibson, C. Michael ;
Hamm, Christian W. ;
Mahaffey, Kenneth W. ;
White, Harvey D. ;
Angiolillo, Dominick ;
Prats, Jayne ;
Harrington, Robert A. ;
Price, Matthew J. .
CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2018, 11 (04)
[6]   Seven-year outcome in the RITA-2 trial: Coronary angioplasty versus medical therapy [J].
Henderson, RA ;
Pocock, SJ ;
Clayton, TC ;
Knight, R ;
Fox, KAA ;
Julian, DG ;
Chamberlain, DA .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2003, 42 (07) :1161-1170
[7]   Association of Immature Platelets With Adverse Cardiovascular Outcomes [J].
Ibrahim, Homam ;
Schutt, Robert C. ;
Hannawi, Bashar ;
DeLao, Timothy ;
Barker, Colin M. ;
Kleiman, Neal S. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2014, 64 (20) :2122-2129
[8]  
Jang SJ, 2010, AM J CARDIOL, V105, p91B
[9]   Prognostic Significance of In-hospital Acquired Thrombocytopenia in Stable Coronary Artery Disease Undergoing Percutaneous Coronary Intervention [J].
Jiang, Ping ;
Gao, Zhan ;
Zhao, Wei ;
Song, Ying ;
Tang, Xiaofang ;
Xu, Jingjing ;
Wang, Huanhuan ;
Jiang, Lin ;
Chen, Jue ;
Qiao, Shubin ;
Yang, Yuejin ;
Gao, Runlin ;
Xu, Bo ;
Yuan, Jinqing .
AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 2019, 358 (01) :19-25
[10]   Clinical correlates and course of thrombocytopenia during percutaneous coronary intervention in the era of abciximab platelet glycoprotein IIb/IIIa blockade [J].
Kereiakes, DJ ;
Berkowitz, SD ;
Lincoff, AM ;
Tcheng, JE ;
Wolski, K ;
Achenbach, R ;
Melsheimer, R ;
Anderson, K ;
Califf, RM ;
Topol, EJ .
AMERICAN HEART JOURNAL, 2000, 140 (01) :74-+