Impact of In-Hospital Acquired Thrombocytopenia in Patients Undergoing Primary Angioplasty for Acute Myocardial Infarction

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

“…6,13,24 Alternatively, thrombocytopenia may simply be a marker of poor substrate and not necessarily implicated in the causal pathway to death. Although our findings are congruent with the results of previous studies demonstrating an association between thrombocytopenia and adverse outcomes, [5][6][7]14,15 we further observe that the degree of risk strongly and independently correlates with the severity of thrombocytopenia, whether determined by the absolute nadir value or relative drop from baseline. In Figure 2A, the inflection point for increased bleeding and mortality risks occurs at a nadir platelet count of Ϸ150ϫ10 9 /L, suggesting that even mild thrombocytopenia, which occurs quite frequently during ACS, is clinically significant.…”

“…6 In the ST-elevation myocardial infarction setting, the incidence of thrombocytopenia has been shown to be as high as 16%, primarily in the setting of fibrinolytic use, whereas among those treated with primary PCI, the incidence (2.5%) was similar to that of patients with NSTE ACS. 14,15 The incidence of thrombocytopenia in routine practice is difficult to extrapolate from these studies because of the restricted criteria for patient inclusion and the lack of a uniform definition of thrombocytopenia across studies.…”

Long‐term mortality after bolus‐only administration of abciximab, eptifibatide, or tirofiban during percutaneous coronary intervention

“…The survival rate after 4 6 1 years follow up was 82.8% in the abciximab group, 91.4% in the eptifibatide group, and 92.6% in the tirofiban group (P 5 0.003 by log-rank test). acquired thrombocytopenia in patients undergoing primary PCI for STEMI is associated with a significant increase in all-cause mortality at 30 days and at 1 year [19]. This could be one of the potential reasons for patients in the abciximab arm in our study to have higher long-term mortality.…”

Minimizing the Risks of Anticoagulants and Platelet Inhibitors

“…This complication increases the risk of bleeding and mortality at 1 year and requires immediate discontinuation of heparin and abciximab. 54 Thrombocytopenia is less common (Ͻ1%) in those treated with a smallmolecule glycoprotein IIb/IIIa inhibitor. It is thought to be mediated via antibody recognition of the ligand-platelet receptor complex, with resulting activation and destruction of the circulating platelets.…”