Abstract 19771: Persistent Thrombocytopenia after Myocardial Infarction is Associated with Increased Short- and Long-Term Mortality
Background: Thrombocytopenia (TCP) occurs commonly in patients hospitalized with acute myocardial infarction (AMI). It is unclear whether persistent TCP after discharge among AMI survivors is associated with worse outcomes.
Methods: We examined the impact of persistent post-discharge TCP on outcomes in a registry of consecutive AMI patients hospitalized between January 2004 and December 2007. In-hospital (IH) TCP was defined by a nadir platelet count < 150 x 109/L. Resolved TCP was defined as IH TCP which resolved within 3 months after discharge while persistent TCP was defined as IH TCP which did not resolve within 3 months.
Results: Of 842 patients hospitalized for a first AMI, we examined data on 617 hospital survivors who had follow-up within 3 months of discharge and documented long-term outcomes. Of those, 474 (76.8%) patients did not experience IH TCP while 42 (6.8%) and 101 (16.4%) had persistent and resolved TCP, respectively (Table). Patients with persistent TCP were older, had worse comorbidities, and were more likely to have TCP at baseline and discharge. There were no inter-group differences in infarct size, major bleeding complications, revascularization, or ejection fraction at discharge. Mortality following discharge was higher at all time-points among AMI patients with persistent TCP compared to patients with resolved or without IH TCP (Figure). Patients with resolved TCP had comparable mortality to those without IH TCP.
Conclusion: Persistent TCP within 3 months after hospital discharge for AMI is associated with significantly increased short- and long-term mortality compared to patients with recovered TCP or without IH TCP.
Author Disclosures: A. Kumar: None. S. Virani: None. S. Bassett: None. M. Alam: None. R. Hira: None. A. Caruso: None. D. Paniagua: None. A. Denktas: None. I. Hamzeh: None. G. Levine: None. C. Ballantyne: None. A. Deswal: None. B. Bozkurt: None. H. Jneid: None.
- © 2014 by American Heart Association, Inc.