title: Baseline platelet count and clinical outcome in acute coronary syndrome.
abstract: BACKGROUND
  It is unclear whether platelet count (PLT) is independently associated with clinical outcome in patients with acute coronary syndrome (ACS).
  
  
  RESULTS
  MEDLINE, EMBASE, the Cochrane library clinical trials registry, ISI Science Citation Index, and ISI Web of Knowledge were searched, supplemented by hand-scanning of references of relevant publications and contacting content experts. Eight studies including 39,324 patients were identified that addressed the following issues: major adverse cardiac events (MACE) and mortality were defined as endpoints; the relative risk (RR) or relative odds and their variance with MACE associated with PLT; studies in which only PLT was quantified. Two investigators independently abstracted information on study design, study and participant characteristics, PLT, clinical outcomes, control for potential confounding factors and risk estimates using a standardized protocol. At 1-month follow-up, compared with the bottom PLT group (< 150 × 10(9)/L), the pooled RRs of mortality and MACE were 1.78 (P=0.14) and 1.63 (P<0.001) for the upper PLT (> 350 × 10(9)/L), respectively. At long-term follow-up (≥ 1 year), the pooled RRs of mortality and MACE were 1.48 (P=0.02) and 1.28 (P=0.02) for the upper PLT, respectively. Moreover, the pooled RR of longitudinal mortality was 1.024 (P=0.03) when PLT was used as a continuous variable.
  
  
  CONCLUSIONS
  Higher PLT at baseline increases the RR of mortality and MACE in ACS patients.
authors.affiliation: Department of Medicine, Zhejiang University, Hangzhou, China.
authors.forename: Yihua
authors.initials: Y
authors.lastname: Wu
authors.forename: Han
authors.initials: H
authors.lastname: Wu
authors.forename: Christian
authors.initials: C
authors.lastname: Mueller
authors.forename: C Michael
authors.initials: CM
authors.lastname: Gibson
authors.forename: Sabina
authors.initials: S
authors.lastname: Murphy
authors.forename: Yu
authors.initials: Y
authors.lastname: Shi
authors.forename: Geng
authors.initials: G
authors.lastname: Xu
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality; D006801:Humans; D010976:Platelet Count; D011237:Predictive Value of Tests; D012307:Risk Factors; D016896:Treatment Outcome