TY - JOUR
T1 - Impact of acquired thrombocytopenia on cardiovascular outcomes in patients with coronary artery disease undergoing percutaneous coronary intervention
T2 - A systematic review and meta-analysis
AU - Ahsan, Muhammad Junaid
AU - Fazeel, Hafiz Muhammad
AU - Haque, Syed Mansur Ul
AU - Malik, Saad Ullah
AU - Latif, Azka
AU - Lateef, Noman
AU - Batool, Syeda Sabeeka
AU - Kousa, Omar
AU - Ahsan, Mohammad Zoraiz
AU - Anwer, Faiz
AU - Andukuri, Venkata
AU - Smer, Aiman
N1 - Funding Information:
We would like to express our very great appreciation to Dr. Amjad Kabach, and Dr. Mark Williams for their valuable and constructive suggestions during the planning and development of this research work.
PY - 2020
Y1 - 2020
N2 - Background: Acquired thrombocytopenia (aTP) is associated with a high frequency of bleeding and ischemic complications in patients undergoing percutaneous coronary intervention (PCI). Herein, we report a meta-analysis evaluating the adverse effects of aTP on cardiovascular outcomes and mortality post-PCI. Methods: A literature search was performed using PubMed, Embase, Cochrane and, clinicaltrials.gov from the inception of these databases through October 2019. Patients were divided into two groups: 1) No Thrombocytopenia (nTP) and 2) Acquired Thrombocytopenia (aTP) after PCI. Primary endpoints were in-hospital, 30-day and all-cause mortality rates at the longest follow-up. The main summary estimate was random effects Risk ratio (RR) with 95% confidence intervals (CIs). Results: Seven studies involving 57,247 participants were included. There was significantly increased in-hospital all-cause mortality (HR 10.73 [6.82–16.88]), MACE (HR 2.96 [2.24–3.94]), major bleeding (HR 4.78 [3.54–6.47]), and target vessel revascularization (TVR) (HR 7.53 [2.8–20.2]), in the aTP group compared to the nTP group. Similarly, aTP group had a statistically significant increased incidence of 30-day all-cause mortality (HR 6.08), MACE (HR 2.77), post-PCI MI (HR 1.98), TVR (HR 5.2), and major bleeding (HR 12.73). Outcomes at longest follow-up showed increased incidence of all-cause mortality (HR 3.98 [1.53–10.33]) and MACE (HR 1.24 [0.99–1.54]) in aTP group, while there was no significant difference for post-PCI MI (HR 0.94 [0.37–2.39]) and TVR (HR 0.96 [0.69–1.32]) between both groups. Conclusions: Acquired Thrombocytopenia after PCI is associated with increased morbidity, mortality, adverse bleeding events and the need for in-hospital and 30-day TVR.
AB - Background: Acquired thrombocytopenia (aTP) is associated with a high frequency of bleeding and ischemic complications in patients undergoing percutaneous coronary intervention (PCI). Herein, we report a meta-analysis evaluating the adverse effects of aTP on cardiovascular outcomes and mortality post-PCI. Methods: A literature search was performed using PubMed, Embase, Cochrane and, clinicaltrials.gov from the inception of these databases through October 2019. Patients were divided into two groups: 1) No Thrombocytopenia (nTP) and 2) Acquired Thrombocytopenia (aTP) after PCI. Primary endpoints were in-hospital, 30-day and all-cause mortality rates at the longest follow-up. The main summary estimate was random effects Risk ratio (RR) with 95% confidence intervals (CIs). Results: Seven studies involving 57,247 participants were included. There was significantly increased in-hospital all-cause mortality (HR 10.73 [6.82–16.88]), MACE (HR 2.96 [2.24–3.94]), major bleeding (HR 4.78 [3.54–6.47]), and target vessel revascularization (TVR) (HR 7.53 [2.8–20.2]), in the aTP group compared to the nTP group. Similarly, aTP group had a statistically significant increased incidence of 30-day all-cause mortality (HR 6.08), MACE (HR 2.77), post-PCI MI (HR 1.98), TVR (HR 5.2), and major bleeding (HR 12.73). Outcomes at longest follow-up showed increased incidence of all-cause mortality (HR 3.98 [1.53–10.33]) and MACE (HR 1.24 [0.99–1.54]) in aTP group, while there was no significant difference for post-PCI MI (HR 0.94 [0.37–2.39]) and TVR (HR 0.96 [0.69–1.32]) between both groups. Conclusions: Acquired Thrombocytopenia after PCI is associated with increased morbidity, mortality, adverse bleeding events and the need for in-hospital and 30-day TVR.
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U2 - 10.1016/j.carrev.2020.07.014
DO - 10.1016/j.carrev.2020.07.014
M3 - Review article
AN - SCOPUS:85089394356
JO - Cardiovascular Revascularization Medicine
JF - Cardiovascular Revascularization Medicine
SN - 1553-8389
ER -