title: Reprint of "Decline in platelet count and long-term post-PCI ischemic events: implication of the intra-aortic balloon pump".
abstract: OBJECTIVE
  Thrombocytopenia (TC) following a percutaneous coronary intervention (PCI) has been associated not only with hemorrhagic, but also with ischemic outcomes. The purpose of this study was to re-examine the relationship of TC with ischemic events at a 1-year follow-up, and investigate the possible associations.
  
  
  RESULTS
  We studied a real-world, unselected population of ischemic patients undergoing PCI, totaling 861 patients-year, and divided into two groups: with TC (delta platelet count ≥25% from baseline to post-PCI during the hospital admission) and without TC. Compared with patients without TC, patients with TC had a higher and earlier incidence of both hemorrhagic and ischemic events. In them, the use of intra-aortic balloon pump (IABP) was ten-fold higher. In Kaplan-Meier curves assessing the contribution of both TC and IABP to outcome, IABP was a univariate detrimental factor additive to the role of TC. In a forced Cox model, the relative decline (delta) in platelet count (p=0.05) and the use of IABP (p=0.0001) were both associated with ischemic outcomes. After excluding all patients with IABP, the delta platelet count was no longer significantly associated with ischemic outcomes (p=0.66). After excluding all patients with shock and all those who undergone thrombolysis, there was still a relationship (p=0.0042) between the delta platelet count and ischemic events.
  
  
  CONCLUSIONS
  In this patient population the use of IABP, but not thrombocytopenia per se, is a possible primary cause of worse ischemic outcomes.
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Italy; Sant'Anna Hospital, Catanzaro, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Schiariti
authors.affiliation: Sant'Anna Hospital, Catanzaro, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Saladini
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Cuturello
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Italy; Sant'Anna Hospital, Catanzaro, Italy.
authors.forename: Loredana
authors.initials: L
authors.lastname: Iannetta
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Italy.
authors.forename: Concetta
authors.initials: C
authors.lastname: Torromeo
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological and Geriatric Sciences, Sapienza University of Rome, Italy. Electronic address: paoloemilio.puddu@uniroma1.it.
authors.forename: Paolo Emilio
authors.initials: PE
authors.lastname: Puddu
keywords: Ischemic events; Outcome; PCI; Platelet count; Thrombocytopenia