Incidence and Prognostic Significance of Thrombocytopenia Developed During Acute Coronary Syndrome in Contemporary Clinical Practice

Abstract

Background-Prior studies examining thrombocytopenia among patients with acute coronary syndromes (ACS) evaluated highly selected patients in a clinical trial setting using varying definitions of thrombocytopenia. Conclusions-Thrombocytopenia, a common complication of ACS, is associated with increased mortality and bleeding risks. Even mild thrombocytopenia or a platelet count drop Ն50% in the setting of normal nadir values is clinically significant. Application of a combined definition for thrombocytopenia using both absolute and relative thresholds permits increased sensitivity for patients at high risk of adverse outcomes.

Predictors of Thrombocytopenia after Self-Expandable Transcatheter Aortic Valve Replacement: A Single-Center Experience from China

“…The concept of major TP primarily described in percutaneous coronary intervention is similar to the one raised in a 2-center, large-scale TAVR study [6,10]. The definition of major TP (a nadir platelet count <100 × 10 9 /L and a >50% decrease in platelet count) was formally described in 2 studies on postprocedural complications and mortality [11,12].…”

“…Postprocedural thrombocytopenia (TP) is a common occurrence after TAVR and surgical aortic valve replacement. Studies have shown that TP can be caused by hemodilution, platelet activation, bone marrow suppression, and mechanical destruction [6,7,8]. Post-TAVR TP has been compared with TP after other cardiac interventions and surgery, and study results reveal that TP is more common and severe after TAVR than after percutaneous coronary intervention and balloon aortic valvuloplasty, but similar to after surgical aortic valve replacement [9,10,11,12,13,14].…”

Minimizing the Risks of Anticoagulants and Platelet Inhibitors

“…In ACS populations, thrombocytopenia (platelet count Ͻ150 000/mm 3 ) occurs in 13% of patients, and moderate thrombocytopenia (platelet count Ͻ100 000/mm 3 ) occurs in Ϸ1%. 49 This complication may arise from heparin-induced thrombocytopenia (HIT), glycoprotein IIb/IIIa inhibitor-associated platelet consumption, or nonimmune causes. Regardless of origin, thrombocytopenia is associated with mortality, major bleeding, and ischemic complications.…”

Early and aggressive treatment of patients with ST-segment elevation myocardial infarction: deciphering recent clinical trials and the timing of optimal platelet inhibition

“…[45][46][47][48] A post hoc analysis from the CADILLAC trial revealed that patients with STEMI managed with primary PCI who developed in-hospital thrombocytopenia were at a significantly higher risk for major bleeding, transfusion, and 30-day mortality than patients without thrombocytopenia. 46 Similarly, an analysis of 52 647 patients enrolled in the GRACE registry demonstrated that STEMI patients who develop thrombocytopenia are at a higher likelihood of major bleeding, recurrent infarction, stroke, and in-hospital mortality.…”