Karam Ayoub1, Meera Marji2, Gbolahan Ogunbayo2, Ahmad Masri3, Ahmed Abdel-Latif2, Khaled Ziada2, Srikanth Vallurupalli4. 1. Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky. Electronic address: karamfayoub@gmail.com. 2. Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky. 3. Division of Cardiovascular Diseases, UPMC-Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, Pennsylvania. 4. Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Cardiovascular Medicine, Central Arkansas Veterans Healthcare System, Little Rock, Arkansas.
Abstract
OBJECTIVES: This study sought to evaluate the impact of chronic thrombocytopenia (cTCP) on clinical outcomes after percutaneous coronary intervention (PCI). BACKGROUND: The impact of cTCP on clinical outcomes after PCI is not well described. Results from single-center observational studies and subgroup analysis of randomized trials have been conflicting and these patients are either excluded or under-represented in randomized controlled trials. METHODS: Using the 2012 to 2014 National (Nationwide) Inpatient Sample database, the study identified patients who underwent PCI with or without cTCP as a chronic condition variable indicator. Propensity score matching was performed using logistic regression to control for differences in baseline characteristics. The primary outcome of interest was in-hospital mortality. Secondary outcomes of interest included in-hospital post-PCI bleeding events, post-PCI blood and platelet transfusion, vascular complications, ischemic cerebrovascular accidents (CVAs), hemorrhagic CVAs, and length of stay. RESULTS: Propensity matching yielded a cohort of 65,130 patients (32,565 with and without cTCP). Compared with those without cTCP, PCI in patients with cTCP was associated with higher risk for bleeding complications (odds ratio [OR]: 2.40; 95% confidence interval [CI]: 2.05 to 2.72; p < 0.0001), requiring blood transfusion (OR: 2.10; 95% CI: 1.80 to 2.24; p < 0.0001), requiring platelet transfusion (OR: 11.70; 95% CI: 6.00 to 22.60; p < 0.0001), higher risk for vascular complications (OR: 1.94; 95% CI: 1.43 to 2.63; p < 0.0001), ischemic CVA (OR: 1.60; 95% CI: 1.20 to 2.10; p = 0.01), and higher in-hospital mortality (OR: 2.30; 95% CI: 1.90 to 2.70; p < 0.0001), but without a significant difference in hemorrhagic CVA (OR: 1.50; 95% CI: 0.70 to 3.10; p = 0.27). CONCLUSIONS: In this large contemporary cohort, patients with cTCP were at higher risk of a multitude of complications, including higher risk of in-hospital mortality.
OBJECTIVES: This study sought to evaluate the impact of chronic thrombocytopenia (cTCP) on clinical outcomes after percutaneous coronary intervention (PCI). BACKGROUND: The impact of cTCP on clinical outcomes after PCI is not well described. Results from single-center observational studies and subgroup analysis of randomized trials have been conflicting and these patients are either excluded or under-represented in randomized controlled trials. METHODS: Using the 2012 to 2014 National (Nationwide) Inpatient Sample database, the study identified patients who underwent PCI with or without cTCP as a chronic condition variable indicator. Propensity score matching was performed using logistic regression to control for differences in baseline characteristics. The primary outcome of interest was in-hospital mortality. Secondary outcomes of interest included in-hospital post-PCI bleeding events, post-PCI blood and platelet transfusion, vascular complications, ischemic cerebrovascular accidents (CVAs), hemorrhagic CVAs, and length of stay. RESULTS: Propensity matching yielded a cohort of 65,130 patients (32,565 with and without cTCP). Compared with those without cTCP, PCI in patients with cTCP was associated with higher risk for bleeding complications (odds ratio [OR]: 2.40; 95% confidence interval [CI]: 2.05 to 2.72; p < 0.0001), requiring blood transfusion (OR: 2.10; 95% CI: 1.80 to 2.24; p < 0.0001), requiring platelet transfusion (OR: 11.70; 95% CI: 6.00 to 22.60; p < 0.0001), higher risk for vascular complications (OR: 1.94; 95% CI: 1.43 to 2.63; p < 0.0001), ischemic CVA (OR: 1.60; 95% CI: 1.20 to 2.10; p = 0.01), and higher in-hospital mortality (OR: 2.30; 95% CI: 1.90 to 2.70; p < 0.0001), but without a significant difference in hemorrhagic CVA (OR: 1.50; 95% CI: 0.70 to 3.10; p = 0.27). CONCLUSIONS: In this large contemporary cohort, patients with cTCP were at higher risk of a multitude of complications, including higher risk of in-hospital mortality.
Authors: Pierre Tibi; R Scott McClure; Jiapeng Huang; Robert A Baker; David Fitzgerald; C David Mazer; Marc Stone; Danny Chu; Alfred H Stammers; Tim Dickinson; Linda Shore-Lesserson; Victor Ferraris; Scott Firestone; Kalie Kissoon; Susan Moffatt-Bruce Journal: J Extra Corpor Technol Date: 2021-06
Authors: Philip Urban; Roxana Mehran; Roisin Colleran; Dominick J Angiolillo; Robert A Byrne; Davide Capodanno; Thomas Cuisset; Donald Cutlip; Pedro Eerdmans; John Eikelboom; Andrew Farb; C Michael Gibson; John Gregson; Michael Haude; Stefan K James; Hyo-Soo Kim; Takeshi Kimura; Akihide Konishi; John Laschinger; Martin B Leon; P F Adrian Magee; Yoshiaki Mitsutake; Darren Mylotte; Stuart Pocock; Matthew J Price; Sunil V Rao; Ernest Spitzer; Norman Stockbridge; Marco Valgimigli; Olivier Varenne; Ute Windhoevel; Robert W Yeh; Mitchell W Krucoff; Marie-Claude Morice Journal: Eur Heart J Date: 2019-08-14 Impact factor: 29.983
Authors: Philip Urban; Roxana Mehran; Roisin Colleran; Dominick J Angiolillo; Robert A Byrne; Davide Capodanno; Thomas Cuisset; Donald Cutlip; Pedro Eerdmans; John Eikelboom; Andrew Farb; C Michael Gibson; John Gregson; Michael Haude; Stefan K James; Hyo-Soo Kim; Takeshi Kimura; Akihide Konishi; John Laschinger; Martin B Leon; P F Adrian Magee; Yoshiaki Mitsutake; Darren Mylotte; Stuart Pocock; Matthew J Price; Sunil V Rao; Ernest Spitzer; Norman Stockbridge; Marco Valgimigli; Olivier Varenne; Ute Windhoevel; Robert W Yeh; Mitchell W Krucoff; Marie-Claude Morice Journal: Circulation Date: 2019-05-22 Impact factor: 29.690
Authors: Dawid Ilnicki; Rafał Wyderka; Przemysław Nowicki; Alicja Sołtowska; Jakub Adamowicz; Adam Ciapka; Joanna Jaroch Journal: SAGE Open Med Case Rep Date: 2019-04-04