title: Effect of Preprocedural Thrombocytopenia on Prognosis After Percutaneous Coronary Intervention.
abstract: To assess early and late outcomes, including bleeding, in patients with thrombocytopenia undergoing percutaneous coronary intervention (PCI).
  
  
  
  We performed a retrospective single-center study of patients with preprocedural thrombocytopenia (platelet count ≤100,000/μL; n=204) undergoing PCI between 2003 and 2015. Inhospital and late outcomes were compared with those of a matched control group without thrombocytopenia (n=1281).
  
  
  
  The most common causes of thrombocytopenia were liver disease, immune-mediated disease, and hematologic malignant neoplasms. Inhospital bleeding events after PCI were similar in patients with thrombocytopenia and matched controls (24 of 146 [16.4%] vs 179 of 1281 [14.0%]; P=.40) and were largely classified as minor using the Bleeding Academic Research Consortium (BARC) classification (89% BARC 1 or 2). There was no significant difference in inhospital death (4 of 146 [2.7%] vs 71 of 1281 [2.0%]; P=.56), but patients with thrombocytopenia had higher rates of platelet and red blood cell transfusion (18 of 146 [12.3%] vs 93 of 1281 [7.2%]; P=.05). During long-term follow-up, Kaplan-Meier estimated rates of bleeding events (BARC ≥2) were higher for thrombocytopenia (at 5 years, 7.9% vs 3.6%; P=.03). Patients with thrombocytopenia had a similar risk of long-term cardiac mortality, but significantly higher rates of noncardiac mortality (at 5 years, 28% vs 21%; P=.02).
  
  
  
  This study suggests that short-term outcomes after PCI in patients with thrombocytopenia were favorable. On long-term follow-up, thrombocytopenia was associated with a higher risk of long-term noncardiac mortality and bleeding.
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Claire E
authors: CE
authors: Raphael
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Daniel B
authors: DB
authors: Spoon
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Malcolm R
authors: MR
authors: Bell
authors: Monash University, Clayton, Australia.
authors: Peter J
authors: PJ
authors: Psaltis
authors: Brigham and Women's Hospital, Boston, MA.
authors: Stephen
authors: S
authors: Kidd
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Shu X
authors: SX
authors: Loh
authors: Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors: Ryan J
authors: RJ
authors: Lennon
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Mandeep
authors: M
authors: Singh
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
authors: Charanjit
authors: C
authors: Rihal
authors: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN. Electronic address: gulati.rajiv@mayo.edu.
authors: Rajiv
authors: R
authors: Gulati
mesh_terms: D017677:Age Distribution; D000368:Aged; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D002423:Cause of Death; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000209:etiology* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000706:statistics & numerical data; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013921:Thrombocytopenia / Q000150:complications* / Q000209:etiology