Percutaneous Coronary Intervention in Acute Coronary Syndrome with Mild-to-Moderate Thrombocytopenia

Yicong Ye; Yongchen Hao; Xiliang Zhao; Jun Liu; Na Yang; Sidney C. Smith Jr; Yong Huo; Gregg C. Fonarow; Junbo Ge; Louise Morgan; Zhaoqing Sun; Danqing Hu; Yiqian Yang; Chang-Sheng Ma; Dong Zhao; Yaling Han; Jing Liu; Yong Zeng

doi:10.1055/a-2225-5263

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2025; 125(03): 218-229
DOI: 10.1055/a-2225-5263

Cellular Haemostasis and Platelets

Percutaneous Coronary Intervention in Acute Coronary Syndrome with Mild-to-Moderate Thrombocytopenia

Yicong Ye‡^*

¹Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Yongchen Hao‡^*

²Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Xiliang Zhao

¹Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Jun Liu

²Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Na Yang

²Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Sidney C. Smith Jr

³Division of Cardiology, University of North Carolina, Chapel Hill, North Carolina, United States

,

Yong Huo

⁴Department of Cardiology, Peking University First Hospital, Beijing, China

,

Gregg C. Fonarow

⁵Division of Cardiology, Geffen School of Medicine at University of California, Los Angeles, California, United States

,

Junbo Ge

⁶Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Fudan University, Zhongshan Hospital, Shanghai, China

,

Louise Morgan

⁷International Quality Improvement Department, American Heart Association, Dallas, Texas, United States

,

Zhaoqing Sun

²Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Danqing Hu

²Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Yiqian Yang

²Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Chang-Sheng Ma

¹Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Dong Zhao

²Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Yaling Han

⁸Department of Cardiology, Cardiovascular Research Institute, General Hospital of Northern Theater Command, Shenyang, Liaoning, China

,

Jing Liu

²Department of Epidemiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

,

Yong Zeng

¹Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China

› Author Affiliations

Abstract

Background Baseline thrombocytopenia is commonly observed in patients with acute coronary syndrome (ACS) requiring percutaneous coronary intervention (PCI).

Aim The purpose of this analysis was to investigate safety and effectiveness of PCI in ACS patients with baseline mild-to-moderate thrombocytopenia.

Methods The data were collected from the Improving Care for Cardiovascular Disease in China–Acute Coronary Syndrome project. A total of 50,009 ACS patients were recruited between July 2017 and December 2019. Among them, there were 6,413 patients with mild-to-moderate thrombocytopenia, defined as a platelet count of ≥50 × 10⁹/L and <150 × 10⁹/L on admission. The primary outcome was in-hospital net adverse clinical events (NACE), consisting of major adverse cardiac events (MACE) and major bleeding events. The associations between PCI and in-hospital outcomes were analyzed by inverse probability treatment weighting (IPTW) method.

Results PCI was performed in 4,023 of 6,413 patients (62.7%). The IPTW analysis showed that PCI was significantly associated with a reduced risk of in-hospital MACE (odd ratio [OR]: 0.45; 95% confidence interval [CI]: 0.31–0.67; p < 0.01) and NACE (OR: 0.59; 95% CI: 0.42–0.83; p < 0.01). PCI was also associated with an increased risk of any bleeding (OR: 1.56; 95% CI: 1.09–2.22; p = 0.01) and minor bleeding (OR: 1.52; 95% CI: 1.00–2.30; p = 0.05), but not major bleeding (OR: 1.51; 95% CI: 0.76–2.98; p = 0.24).

Conclusion Compared with medical therapy alone, PCI is associated with better in-hospital outcomes in ACS patients with mild-to-moderate thrombocytopenia. Further studies with long-term prognosis are needed.

Keywords

thrombocytopenia - acute coronary syndrome - percutaneous coronary intervention - platelet

Full Text

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Supplementary Material

Supplementary Material