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A systematic review and meta‐analysis of impact of baseline thrombocytopenia on cardiovascular outcomes and mortality in patients undergoing percutaneous coronary intervention
Author(s) -
Ahsan Muhammad J.,
Lateef Noman,
Latif Azka,
Malik Saad U.,
Batool Syeda S.,
Fazeel Hafiz M.,
Ahsan Mohammad Z.,
Faizi Zaheer,
Thandra Abhishek,
Mirza Mohsin,
Kabach Amjad,
Core Michael Del
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29405
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , mace , relative risk , incidence (geometry) , confidence interval , meta analysis , cochrane library , surgery , myocardial infarction , physics , optics
Background Thrombocytopenia (TP) is associated with higher incidence of bleeding in the setting of percutaneous coronary intervention (PCI) leading to increased morbidity and mortality. Herein, we report a meta‐analysis evaluating the effects of baseline thrombocytopenia (bTP) on cardiovascular outcomes in patients undergoing PCI. Methods Literature search was performed using PubMed, Embase, Cochrane library and clinicaltrials.gov from inception till October 2019. Patients were divided into two groups: Patients with (a) no Thrombocytopenia (nTP) (b) bTP before PCI. Primary endpoints were in‐hospital, 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 A total of 6,51,543 patients from 10 retrospective studies were included. There was increased in‐hospital all‐cause mortality (RR 2.58 [1.7–3.8], p < .001) and bleeding (RR 2.37 [1.41–3.98], p < .005), in the bTP group compared to the nTP group. There was no difference for in‐hopsital major adverse cardiovascular outcomes (MACE) (RR 1.38 [0.94–2.0], p < .10), post‐PCI MI (RR 1.17 [0.9–1.5], p = .19) and TVR (RR 1.65 [0.8–3.6], p = .21), respectively. Outcomes at longest follow‐up showed increased incidence of all‐cause mortality (RR 1.86 [1.2–2.9], p < .006) and bleeding (RR 1.72 [1.1–2.9], p = .04) in bTP group, while there was no significant difference for post‐PCI MI (RR 1.07 [0.91–1.3], p = .42), MACE (RR 1.86 [0.69–1.8], p = .68) and TVR (RR 1.1 [0.9–1.2], p = .93) between both groups. Conclusions bTP in patients undergoing PCI is associated with increased mortality and predicts risk of bleeding.