Thrombocytopoenia worsens outcomes in acute myocardial infarction patients

Thrombocytopoenia increases the risk of bleeding, poor cardiovascular outcomes and death among patients with acute myocardial infarction, a recent study suggests.

Researchers accessed the data of 6,717,769 patients who were hospitalized with a primary diagnosis of acute myocardial infarction. Of these, 219,351 had thrombocytopoenia (3.3 percent; mean age, 70.70±0.08 years; 33.7 percent female), while the remaining 6,498,418 did not (mean age, 67.41±0.06 years; 39.8 percent female).

Patients with thrombocytopoenia were more likely to bleed while admitted than their counterparts without the condition (29.3 percent vs 11.4 percent; p<0.001; odds ratio [OR], 3.62, 95 percent CI, 3.48–3.76).

The same was true for bleeding episodes requiring intervention (OR, 3.33, 3.22–3.45), haemorrhagic stroke (OR, 2.09, 1.80–2.44), and the need for transfusions of red blood cells (OR, 3.37, 3.25–3.50) and platelets (OR, 8.35, 7.77–8.97). Sensitivity analysis focusing on patients with primary thrombocytopoenia did not change the principal findings.

Thrombocytopoenia also complicated cardiovascular outcomes in acute myocardial infarction patients. For instance, patients with the condition were at a significantly greater risk of in-hospital mortality (OR, 1.84, 1.77–1.90), ischaemic stroke (OR, 1.73, 1.62–1.84), cardiogenic shock (OR, 3.41, 3.29–3.54) and cardiac arrest (OR, 1.98, 1.90–2.07).

“Prospective investigation into the management of acute myocardial infarction in the setting of thrombocytopoenia, particularly with regard to revascularization and transfusion strategies, is necessary to mitigate the poor prognosis of this expanding population,” said researchers.