Factors Associated with Low Admission Platelet Count in Adults with Acute Aortic Dissection

Abstract

Purpose: Platelets are crucial components of the coagulation processes, and low admission platelet count (PLC) is associated with adverse clinical outcomes in patients with Stanford type A acute aortic dissection (AAD). Methods: A total of 130 consecutive patients undergoing Stanford type A AAD surgery in Beijing Anzhen Hospital were enrolled between January 2013 and July 2014. Preoperative clinical and laboratory data from patients were collected. Multiple regression analyses were used to determine the independent factors of low admission platelets. Results: Adjusted multiple regression analysis showed that age (β: −1.069, 95% confidence interval [CI]: −2.109, −0.029), sex (β: −29.973, 95% CI: −56.512, −3.433), tissue factor pathway inhibitor (TFPI; β: 0.197, 95% CI: 0.039, 0.354), fibrinogen degradation product (FDP) (β: −0.476, 95% CI: −0.879, −0.074), and attack time (β: 11.125, 95% CI: 7.963, 14.287) were significantly associated with admission PLC. Admission PLC increased with attack time up to the 3 days (β: 16.2, 95% CI: 12.1, 20.2). Conclusions: We found that increasing age, male patients, patients with lower serum levels of TFPI and higher serum levels of FDP, and patients with a shorter attack time were significantly associated with lower PLC at admission. Moreover, the turning point of attack time is 3 days after the onset of dissection.

U-shaped relationship between platelet–lymphocyte ratio and postoperative in-hospital mortality in patients with type A acute aortic dissection

“…Furthermore, massive platelet consumption can increase the hazards of dissection rupture and aggravate organ ischemia [ 10 ]. Many studies have demonstrated that a low platelet count is associated with increased in-hospital mortality in patients with AAAD [ 6 , 30 , 31 ]. Contrarily, low lymphocyte counts can reflect the severity of inflammation, which is related to poor outcomes in patients with cardiovascular diseases [ 32 ].…”

Admission Time and Surgical Technique are Important in Aortic Dissection Treatment Results

“…The large false lumen is associated with poor results. Accordingly, there are publications in the literature showing that low platelet count may be associated with poor results [ 6 ] . Therefore, establishing a relationship between preoperative platelet-lymphocyte ratio (PLR) and mortality can also provide misleading results.…”