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Relationship between platelet count and 30-day clinical outcomes after percutaneous coronary interventions. Pooled

Raisuke Iijima1, Gjin Ndrepepa, Julinda Mehilli

  • 1Deutsches Herzzentrum, Lazarettstr. 36, 80636 Munich, Germany. raisuke329@aol.com

Thrombosis and Haemostasis
|October 17, 2007
PubMed

Insights

Baseline platelet count in patients undergoing percutaneous coronary intervention (PCI) after clopidogrel pre-treatment does not affect major adverse cardiac events (MACE). However, higher platelet counts are linked to increased 30-day mortality and Q-wave myocardial infarction.

Area of Science:

  • Cardiology
  • Hematology

Background:

  • Platelets are crucial in major adverse cardiac events (MACE) post-percutaneous coronary intervention (PCI).
  • The relationship between platelet count and outcomes in patients pre-treated with clopidogrel before PCI remains unclear.

Purpose of the Study:

  • To investigate the impact of baseline platelet count on 30-day MACE and mortality in patients with coronary artery disease (CAD) undergoing PCI after clopidogrel pre-treatment.

Main Methods:

  • Analysis of 5,256 patients from four randomized trials (ISAR-REACT, ISAR-SMART2, ISAR-SWEET, ISAR-REACT2).
  • Patients received 600 mg clopidogrel pre-PCI, with platelet counts categorized into tertiles.
  • Primary endpoint: 30-day MACE; Secondary endpoint: 30-day mortality.

Main Results:

  • No significant difference in 30-day MACE incidence across platelet count tertiles (P=0.76).
  • A significant increase in 30-day mortality was observed in the upper platelet count tertile (P=0.04).
  • Higher incidence of Q-wave myocardial infarction in the upper tertile (P=0.02).

Conclusions:

  • Baseline platelet count is an independent predictor of 30-day mortality in patients with CAD undergoing PCI after clopidogrel pre-treatment.
  • While MACE rates were similar, elevated platelet counts correlate with increased mortality risk.

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