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Mayo Clin Proc ; 91(8): 1035-44, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27492910

RESUMO

OBJECTIVE: To assess early and late outcomes, including bleeding, in patients with thrombocytopenia undergoing percutaneous coronary intervention (PCI). PATIENTS AND METHODS: We performed a retrospective single-center study of patients with preprocedural thrombocytopenia (platelet count ≤100,000/µL; n=204) undergoing PCI between 2003 and 2015. Inhospital and late outcomes were compared with those of a matched control group without thrombocytopenia (n=1281). RESULTS: The most common causes of thrombocytopenia were liver disease, immune-mediated disease, and hematologic malignant neoplasms. Inhospital bleeding events after PCI were similar in patients with thrombocytopenia and matched controls (24 of 146 [16.4%] vs 179 of 1281 [14.0%]; P=.40) and were largely classified as minor using the Bleeding Academic Research Consortium (BARC) classification (89% BARC 1 or 2). There was no significant difference in inhospital death (4 of 146 [2.7%] vs 71 of 1281 [2.0%]; P=.56), but patients with thrombocytopenia had higher rates of platelet and red blood cell transfusion (18 of 146 [12.3%] vs 93 of 1281 [7.2%]; P=.05). During long-term follow-up, Kaplan-Meier estimated rates of bleeding events (BARC ≥2) were higher for thrombocytopenia (at 5 years, 7.9% vs 3.6%; P=.03). Patients with thrombocytopenia had a similar risk of long-term cardiac mortality, but significantly higher rates of noncardiac mortality (at 5 years, 28% vs 21%; P=.02). CONCLUSION: This study suggests that short-term outcomes after PCI in patients with thrombocytopenia were favorable. On long-term follow-up, thrombocytopenia was associated with a higher risk of long-term noncardiac mortality and bleeding.


Assuntos
Transfusão de Sangue/estatística & dados numéricos , Hemorragia/etiologia , Intervenção Coronária Percutânea/efeitos adversos , Trombocitopenia/complicações , Distribuição por Idade , Idoso , Estudos de Casos e Controles , Causas de Morte , Comorbidade , Feminino , Seguimentos , Hemorragia/terapia , Mortalidade Hospitalar , Humanos , Estimativa de Kaplan-Meier , Masculino , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Intervenção Coronária Percutânea/estatística & dados numéricos , Prognóstico , Estudos Retrospectivos , Medição de Risco , Distribuição por Sexo , Trombocitopenia/etiologia
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