• NEWS . 10 Feb 2020
  • Blood platelet count at hospital admission impacts long-term mortality in ACS patients

  • Patients with acute coronary syndrome (ACS) and who have thrombocytopenia or thrombocytosis at hospital admission have almost twice the mortality rate at 5 years compared with those with normal blood platelet counts.

    This study, with data obtained from the US National Health Fund database, included 3,162 patients with a median follow-up of 27.2 months (interquartile range, 12.5–46.8 months; maximum 68.7 months). Patients with thrombocytopenia and thrombocytosis yielded a higher maximal analysed 5-year mortality rate compared with patients with a normal platelet count (45.8% and 47.7% vs 24.2%, respectively; p<0.00001). This was mainly driven by higher deaths at 1–2 years after ACS. Thrombocytopenia was defined as a blood platelet count <150 g/L and thrombocytosis as a blood platelet count >450 g/L.

    Additional platelet indices that were tested included plateletcrit (PCT), mean platelet volume (MPV), platelet distribution width (PDW) and platelet larger cell ratio (P-LCR).

    The 5-year long-term mortality was also significantly higher in patients with abnormal PCT and MPV levels compared with patients with PCT and MPV within the normal range. Other platelet indices (PDW and P-LCR) were not associated with a worse outcome. The Cox proportional hazards model revealed that thrombocytopenia at admission was independently associated with higher long-term mortality after ACS (risk ratio, 1.83; 95% confidence interval, 1.1–3.0; p=0.01).

    Małyszczak A, et al. Blood platelet count at hospital admission impacts long-term mortality in patients with acute coronary syndrome. Cardiology 2020. doi: 10.1159/000505640. [Epub ahead of print]