Association between baseline platelet count and severe adverse outcomes following percutaneous coronary intervention

Area of Science:

• Cardiology
• Hematology
• Interventional Cardiology

Background:

• Platelet count (PC) is a readily available biomarker.
• Its role in predicting outcomes after percutaneous coronary intervention (PCI) remains debated.
• Real-world data on baseline PC and severe adverse events post-PCI are crucial.

Purpose of the Study:

• To assess the association between baseline platelet count (PC) and severe adverse outcomes following PCI.
• To evaluate the prognostic value of low, normal, and high baseline PC in a large real-world cohort.
• To determine if baseline PC predicts mortality or major bleeding after PCI.

Main Methods:

• Retrospective analysis of 18,788 patients undergoing PCI with drug-eluting stents.
• Patients stratified into low (< 150 × 1000/µL), normal (150-300 × 1000/µL), and high (≥ 300 × 1000/µL) baseline PC groups.
• Primary endpoints: in-hospital and follow-up all-cause mortality. Secondary endpoint: major bleeding requiring transfusion.

Main Results:

• No significant differences in in-hospital (0.6% vs 0.4% vs 0.4%) or follow-up mortality (0.9% vs 0.6% vs 0.7%) across PC groups (P=0.259 and P=0.079).
• Multivariate analysis showed no increased mortality risk for low or high PC compared to normal PC.
• No significant difference in major bleeding rates (0.5% vs 0.3% vs 0.3%; P=0.320) or increased risk after adjustment.

Conclusions:

• Baseline platelet count is not significantly associated with severe adverse outcomes after PCI in current real-world practice.
• The study did not find an independent prognostic value for baseline PC, except possibly in transfemoral PCI subgroups.
• These findings suggest PC is not a reliable predictor of mortality or major bleeding post-PCI.