Decline in platelet count and long-term post-PCI ischemic events: Implication of the intra-aortic balloon pump

Schiariti, Michele; Saladini, Patrizia; Cuturello, Domenico; Iannetta, Loredana; Torromeo, Concetta; Puddu, Paolo Emilio

doi:10.1016/j.vph.2013.11.002

Cited by 15 publications

(4 citation statements)

References 32 publications

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“…It is interesting that, in some cases, thrombocytopenia may also indicate increased risk of ischemic events, which seems to be a paradox to our results4950. However, further studies found that, in the population of ischemic patients, it was the use of intra-aortic balloon pump (IABP), but not thrombocytopenia per se, serves as a possible primary cause of adverse ischemic events4950.…”

Section: Discussioncontrasting

confidence: 54%

“…However, further studies found that, in the population of ischemic patients, it was the use of intra-aortic balloon pump (IABP), but not thrombocytopenia per se, serves as a possible primary cause of adverse ischemic events4950. It reminds us that when we use PLR to predict the prognosis of ACS, we should make our judgment according to each specific matter considering possible confounding factors.…”

Section: Discussionmentioning

confidence: 99%

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Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis

Liu²,

Tang

2017

Sci Rep

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Recent studies have shown platelet to lymphocyte ratio (PLR) to be a potential inflammatory marker in cardiovascular diseases. We performed a meta-analysis to systematically evaluate the prognostic role of PLR in acute coronary syndrome (ACS). A comprehensive literature search up to May 18, 2016 was conducted from PUBMED, EMBASE and Web of science to identify related studies. The risk ratio (RR) with 95% confidence interval (CI) was extracted or calculated for effect estimates. Totally ten studies involving 8932 patients diagnosed with ACS were included in our research. We demonstrated that patients with higher PLR level had significantly higher risk of in-hospital adverse outcomes (RR = 2.24, 95%CI = 1.81–2.77) and long-term adverse outcomes (RR = 2.32, 95%CI = 1.64–3.28). Sensitivity analyses confirmed the stability of our results. We didn’t detect significant publication bias by Begg’s and Egger’s test (p > 0.05). In conclusion, our meta-analysis revealed that PLR is promising biomarker in predicting worse prognosis in ACS patients. The results should be validated by future large-scale, standard investigations.

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Section: Discussioncontrasting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis

Liu²,

Tang

2017

Sci Rep

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“…Previous researches 41 42 showed thrombocytopenia (TC) is associated with increased risk of bleeding and ischemic events. Studies also showed that intra-aortic balloon pump (IABP) was a cause of both TC 43 and PPA 40 and influenced the long-term ischemic events. Although the significant difference in mortality between patients with and without baseline TC was not found in our study, the change of platelet count following IABP should be taken into account in the process of DAPT.…”

Section: Discussionmentioning

confidence: 99%

Impact of Anemia and Dual Antiplatelet Therapy on Mortality in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

Wang

Yang

et al. 2015

Sci Rep

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The objective was to assess the impact of baseline anemia on all-cause mortality and whether 12-month dual antiplatelet therapy (DAPT) affects 1-year mortality linked to anemia in patients after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). 4109 enrolled patients divided into three groups based on their pre-procedural hemoglobin (Hb) level: Hb < 100 mg/L represented moderate-severe anemia; 100 mg/L ≤ Hb < 120 mg/L for women and 100 mg/L ≤ Hb < 130 mg/L for men represented mild anemia; Hb ≥ 120 mg/L for women and Hb≥130 mg/L for men represented no anemia. DAPT medications were prescribed when patients were discharged. There were significant differences in 30-day and 1-year mortality between moderate-severe anemia and no anemia patients (HR 8.05, 95% CI 1.46 to 44.33, P = 0.017; HR 3.93, 95% CI 1.11 to 13.98, P = 0.034), and in long-term mortality between anemia and no anemia groups (HR 1.82, 95% CI 1.17 to 2.83, P = 0.008 for mild anemia; HR 3.19,95% CI 1.29 to 7.86, P = 0.012 for moderate-severe anemia). There was not significant interaction between 12-month DAPT and anemia on mortality in anemic patients (P for interaction > 0.05). Anemia shows association with increased all-cause mortality in patients undergoing PCI. Twelve-month DAPT does not show synergy with anemia to increase the risk of all-cause 1-year mortality in anemic patients after PCI.

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“…Longer CPB duration and the use of IABP have been associated with an increased risk of thrombocytopenia. Studies have reported varying degrees of PLT dysfunction and reduction associated with IABP use ( 22 , 23 ). These effects may be influenced by factors such as PLT activation, shear stress, PLT adhesion to the IABP surface, and altered blood flow dynamics ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

Risk factors and prediction model for thrombocytopenia following coronary artery bypass graft surgery in elderly Chinese population

Zhao,

Zhang,

Liu

et al. 2024

J Thorac Dis

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Background Thrombocytopenia, a common complication of coronary artery bypass graft (CABG) surgery, is particularly prevalent among elderly individuals. This study developed a risk prediction model utilizing preoperative and intraoperative variables to identify high-risk elderly patients prone to developing thrombocytopenia. Methods The patients were retrospectively recruited from Beijing Anzhen Hospital between February 2019 and December 2020. Postoperative thrombocytopenia was defined as a postoperative platelet (PLT) count <100×10 9 /L as measured within 7 days after surgery. The entire population was randomly split into derivation and validation sets in a 7:3 ratio. The derivation set underwent variable screen by the least absolute shrinkage and selection operator (LASSO) regression method. To evaluate the predictive ability of the model for thrombocytopenia, decision curve analysis (DCA) and receiver operating characteristic (ROC) curves were generated in the derivation and validation sets. Results A total of 1,773 patients were recruited in this study, with random assignment to either the derivation set (1,242 cases) or the validation set (531 cases). LASSO regression was utilized the risk factors associated with thrombocytopenia, resulting in selection of preoperative baseline variables: body mass index (BMI), estimated glomerular filtration rate (eGFR), B-type natriuretic peptide (BNP), preoperative PLT, and use of beta-blocker, and intraoperative variables: red blood cell (RBC) transfusion, plasma transfusion, use of intra-aortic balloon pump (IABP) and cardiopulmonary bypass (CPB), reoperation for bleeding, washed RBC transfusion volume, and use of epinephrine. The logistic regression was employed to establish the risk prediction. The area under the ROC curve (AUC) for the derivation set was 0.900 [95% confidence interval (CI): 0.880−0.920], while for the validation cohort, it was 0.897 (95% CI: 0.866−0.928). Conclusions The model incorporating significant preoperative and intraoperative variables exhibited good predictive performance for thrombocytopenia in elderly patients undergoing CABG surgery.

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Decline in platelet count and long-term post-PCI ischemic events: Implication of the intra-aortic balloon pump

Abstract: In this patient population the use of IABP, but not thrombocytopenia per se, is a possible primary cause of worse ischemic outcomes.

Cited by 15 publications

References 32 publications

Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis

Platelet to lymphocyte ratio in the prediction of adverse outcomes after acute coronary syndrome: a meta-analysis

Impact of Anemia and Dual Antiplatelet Therapy on Mortality in Patients Undergoing Percutaneous Coronary Intervention with Drug-Eluting Stents

Risk factors and prediction model for thrombocytopenia following coronary artery bypass graft surgery in elderly Chinese population

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