title: Impact of aspirin therapy in cancer patients with thrombocytopenia and acute coronary syndromes.
abstract: BACKGROUND
  Patients with cancer who have thrombocytopenia may experience acute coronary syndromes (ACS), and the use of aspirin (ASA) poses an increased risk of bleeding. The purpose of this study was to test the hypothesis that the benefit of ASA therapy in the treatment of ACS would extend to cancer patients with thrombocytopenia and outweigh the risks of severe bleeding.
  
  
  METHODS
  The records of all cancer patients diagnosed with an ACS in 2001 and referred for cardiology consultation were reviewed. Patients were divided into 2 groups on the basis of platelet count, >100 cells k/microL and < or = 100 cells k/microL. Data were collected on the use of ASA therapy, bleeding complications, and survival rates. The authors assessed group differences by using the Wilcoxon rank sum test or 2-tailed Fisher exact test, as appropriate. Univariate and multivariate logistic regression models were used to assess factors potentially associated with 7-day survival.
  
  
  RESULTS
  In cancer patients with ACS and thrombocytopenia, those who did not receive ASA had a 7-day survival rate of 6% compared with 90% in those who did receive ASA (P < .0001). There were no severe bleeding complications. Patients with a platelet count (>100 cells k/microL) who received ASA had a 7-day survival rate of 88% compared with 45% in those who did not receive ASA (P = .0096).
  
  
  CONCLUSIONS
  Therapy with ASA was associated with a significantly improved 7-day survival after ACS in cancer patients, with or without thrombocytopenia, and not associated with more severe bleeding.
authors.affiliation: Department of Anesthesiology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Mona G
authors.initials: MG
authors.lastname: Sarkiss
authors.forename: S Wamique
authors.initials: SW
authors.lastname: Yusuf
authors.forename: Carla L
authors.initials: CL
authors.lastname: Warneke
authors.forename: Gregory
authors.initials: G
authors.lastname: Botz
authors.forename: Nasser
authors.initials: N
authors.lastname: Lakkis
authors.forename: Cheryl
authors.initials: C
authors.lastname: Hirch-Ginsburg
authors.forename: J Chris
authors.initials: JC
authors.lastname: Champion
authors.forename: Joseph
authors.initials: J
authors.lastname: Swafford
authors.forename: Andrew D S
authors.initials: AD
authors.lastname: Shaw
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lenihan
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Durand
mesh_terms: D000208:Acute Disease; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D003327:Coronary Disease / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D008297:Male; D008499:Medical Records; D009203:Myocardial Infarction / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*; D009369:Neoplasms / Q000150:complications*; D017063:Outcome Assessment, Health Care; D010976:Platelet Count; D012189:Retrospective Studies; D015996:Survival Rate; D013921:Thrombocytopenia / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin