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Thrombocytopenia is a predictor of increased risk of in-hospital mortality in patients undergoing PCI, Canadian researchers report in the American Heart Journal.

Thrombocytopenia is a predictor of increased risk of in-hospital mortality in patients undergoing percutaneous coronary intervention (PCI), Canadian researchers report in the July issue of the American Heart Journal.

Dr. Vladimir Dzavik and colleagues at the University of Toronto note that thrombocytopenia affects approximately 5.9 per cent of patients who undergo PCI at their institution, but the condition's effect on PCI outcome has not been well studied.

In their review of data on 639 patients with thrombocytopenia and 10,182 without the condition who underwent PCI at their hospital, the researchers found a significantly higher in-hospital death rate in the thrombocytopenia group (1.9 per cent, versus 0.6 per cent in patients without thrombocytopenia), attributable to increased mortality in patients with thrombocytopenia undergoing urgent PCI (3.55 per cent, versus 1.5 per cent in no-thrombocytopenia patients).

Thrombocytopenia patients also had significantly higher rates of major bleeding complications (1.7 per ent versus 0.8 per cent) and gastrointestinal bleeding (1.1 per cent versus 0.5 per cent).

Multivariate analysis showed that thrombocytopenia at baseline was an independent risk factor for in-hospital mortality in patients undergoing urgent PCI (odds ratio, 2.07).

"Thrombocytopenia should be considered an important addition to PCI risk prediction models," the investigators conclude, "to improve their precision and clinical applicability."

Am Heart J 2008;156:120-124