title: Impact of baseline thrombocytopenia on the early and late outcomes after ST-elevation myocardial infarction treated with primary angioplasty: analysis from the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial.
abstract: BACKGROUND
  Thrombocytopenia (TP) is a common abnormality in patients presenting with acute coronary syndrome. Whether baseline TP has any influence on the outcome of patients treated with primary angioplasty for acute myocardial infarction is unknown.
  
  
  METHODS
  We sought to detect the impact of baseline TP on the early and late outcomes of patients with ST-elevation myocardial infarction in the HORIZONS-AMI trial that included a protocol of immediate angiography and primary percutaneous coronary intervention.
  
  
  RESULTS
  Baseline TP was found in 4.2% of patients and was associated with a higher incidence of cardiovascular mortality, major bleeding, and major cardiovascular events at short- and long-term follow-up. The 30-day rates of death, major bleeding, major cardiac events, and major cardiac events plus major bleeding were 6.2%, 11.9%, 9.6%, and 18.5% in the TP group, respectively, compared with 2.1%, 7%, 5.2%, and 10.8% in those without TP (P < .05 for all). Similarly, event rates at 2 years were 11.3%, 12.7%, 24.7%, and 30.8% compared with 5.1%, 7.9%, 18.5%, and 23.3% (P < .05). By multivariate analysis, baseline TP was an independent predictor of 30-day net adverse clinical events but not of any 2-year events.
  
  
  CONCLUSIONS
  We found that baseline TP in patients with ST-elevation myocardial infarction undergoing routine angiography and primary percutaneous coronary intervention is strongly associated with early adverse events and is a maker of late events, related to both ischemia and bleeding.
authors.affiliation: Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Diaa A
authors.initials: DA
authors.lastname: Hakim
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
authors.forename: Adriano
authors.initials: A
authors.lastname: Caixeta
authors.forename: Eugenia
authors.initials: E
authors.lastname: Nikolsky
authors.forename: Alexandra J
authors.initials: AJ
authors.lastname: Lansky
authors.forename: Jeffrey W
authors.initials: JW
authors.lastname: Moses
authors.forename: Bimmer
authors.initials: B
authors.lastname: Claessen
authors.forename: Elias
authors.initials: E
authors.lastname: Sanidas
authors.forename: Harvey D
authors.initials: HD
authors.lastname: White
authors.forename: E Magnus
authors.initials: EM
authors.lastname: Ohman
authors.forename: Steven V
authors.initials: SV
authors.lastname: Manoukian
authors.forename: Martin
authors.initials: M
authors.lastname: Fahy
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents; D013921:Thrombocytopenia / Q000150:complications*; D013997:Time Factors; D016896:Treatment Outcome