Relation of platelet count to bleeding and vascular complications in patients undergoing coronary angiography

Vascular and bleeding complications are associated with significant morbidity and mortality, limited data are available on the relation between these complications and the platelet count in patients undergoing coronary angiography. We, therefore, performed a retrospective cohort analysis of 3,466 consecutive adults undergoing coronary angiography at a single institution during a 2-year period. The mean + or - SD age was 60 + or - 13 years; 58% of the patients were men, 67% were white, and 27% were black. The mean platelet count was 242 + or - 86 x 10(9)/L. A total of 143 bleeding or vascular complications (4.2%), as defined using the American College of Cardiology CathPCI Registry criteria, a part of the American College of Cardiology National Cardiovascular Disease Registry, occurred. The risk of complications increased with increasing platelet counts. Compared to the quartile with the lowest platelet counts, the odds ratio (OR) for complications was 1.41 for the second quartile (95% confidence interval 0.83 to 2.37, p = 0.20), 1.74 for the third quartile (95% confidence interval 1.04 to 2.93, p = 0.04), and 2.04 for the fourth quartile (95% confidence interval 1.21 to 3.44, p = 0.008). On multivariate logistic regression analysis, age, percutaneous coronary intervention, and increasing platelet counts were independent predictors of bleeding and vascular complications. When the analysis was limited to the 2,220 patients undergoing diagnostic coronary angiography without percutaneous coronary intervention, an increasing platelet quartile was a significant predictor of vascular and/or bleeding complications (OR 1.88, p = 0.08; OR 2.48, p = 0.01; OR 2.52, p = 0.01 for the second, third, and fourth quartiles, respectively). In conclusion, the baseline platelet count was a strong and independent risk factor for bleeding and vascular complications in patients undergoing coronary angiography.