Cardiovascular manifestations in patients with thrombotic thrombocytopenic purpura: a single-center experience.
BACKGROUND
Cardiovascular manifestation in patients with thrombotic thrombocytopenic purpura.


OBJECTIVE
The aim of this study was to investigate the incidence of acute myocardial infarction (AMI), arrhythmias, congestive heart failure, and mortality in patients hospitalized for thrombotic thrombocytopenic purpura (TTP).


METHODS
Thirty-eight patients (27 women and 11 men), mean age 44 years, were hospitalized with the diagnosis of TTP confirmed by a hematologist. We investigated the incidence of AMI which developed during hospitalization for TTP. AMI was diagnosed by new electrocardiographic changes, increased serum cardiac troponin I levels, and clinical symptomatology. The patients with AMI were also monitored for development of arrhythmias during hospitalization.


RESULTS
Of the 38 patients, 8 (21%) developed new Q-wave AMI. There was no significant difference in baseline characteristics between patients who developed AMI and those who did not develop AMI. Of the 8 patients with AMI, 2 (25%) developed atrial fibrillation, 1 (13%) developed atrial flutter, 1 (13%) developed supraventricular tachycardia, and 2 (25%) developed congestive heart failure. Death occurred in 3 of 8 patients (38%) with AMI and in 1 of 30 patients (3%) without AMI (P < 0.01).


CONCLUSIONS
New Q-wave AMI developed in 21% of 38 patients hospitalized with TTP. Supraventricular tachyarrhythmias developed in 50% of 8 patients with TTP who developed AMI. Patients hospitalized for TTP should be monitored for adverse cardiac events due to the high incidence of new AMI, supraventricular tachyarrhythmias, and mortality.
Gandhi
Kaushang
K
Department of Medicine, Cardiology and Hematology Divisions, New York Medical College, Valhalla, New York, USA. kaushanggandhi@yahoo.com
Aronow
Wilbert S
WS
Desai
Harit
H
Amin
Harshad
H
Sharma
Mala
M
Lai
Hoang M
HM
Singh
Parminder
P
D051722:ADAM Proteins / Q000172:deficiency; D000071120:ADAMTS13 Protein; D000328:Adult; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D011697:Purpura, Thrombotic Thrombocytopenic / Q000150:complications*; D012307:Risk Factors; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D019210:Troponin I; D051722:ADAM Proteins; D000071120:ADAMTS13 Protein; C099604:ADAMTS13 protein, human
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