Abstract 4455: The Impact of Platelet Count Decline on Clinical Outcome of Patients Undergoing Percutaneous Coronary Intervention
BACKGROUND: Severe decline in platelet count (DPC) ≥ 50% has been shown to be predictor of outcome after PCI. The prognosis of mild or moderate DPC is unknown. This study aimed to examine the impact of various degrees of DPC on clinical outcome.
METHODS: The study included 10,146 consecutive patients who were subjected to PCI. The population was divided in four groups according to the magnitude of the decline in platelet post PCI: no DPC (DPC ≤ 10 %), minor DPC (10 –25 %), mild DPC (26 –50 %) and severe DPC (≥50%). The primary endpoint for this analysis was the composite criteria of death-MI at 30 days.
RESULTS: Among the 10,146 patients, 36 % had a DPC ≤10 %, 47.7% had a DPC 10 –25%, 14% had a DPC 26 –50% and 2.3% had a DPC ≥50%. At 30 days, there was a worsening of clinical outcome with the severity of DPC (table 1⇓). In univariate analysis, numerous variables were detected associated with the risk of death-MI at 30 days including both mild and severe DPC. After adjustment in multivariate analysis, DPC (25–50 %) and DPC (≥50%) were independently associated with the composite criteria death-MI at 30 days. All independent predictors in multivariate analysis are listed in table 2⇓.
CONCLUSIONS: DPC after PCI is an independent predictor of death-MI at 30 days. The clinical significance of DPC is not limited to major DPC (≥50%) but also seen with moderate DPC (26 –50 %). Careful attention to platelet count is required in patients subjected to PCI who experienced more than 25% decline in their platelet count following the intervention.