Baseline platelet count in percutaneous coronary intervention: a dose-response meta-analysis

Area of Science:

• Cardiovascular Medicine
• Hematology
• Interventional Cardiology

Background:

• The prognostic value of baseline platelet count in patients undergoing percutaneous coronary intervention (PCI) remains incompletely understood.
• Understanding this relationship is crucial for risk stratification and management post-PCI.

Purpose of the Study:

• To elucidate the dose-response relationship between baseline platelet count and clinical outcomes following PCI.
• To assess the prognostic significance of platelet count for mortality, major adverse cardiovascular events (MACE), and bleeding.

Main Methods:

• A comprehensive meta-analysis of published studies was conducted, searching PubMed, Scopus, and Web of Science.
• Included 19 studies with 217,459 patients, analyzing associations between platelet count and clinical endpoints.
• Employed random-effects pairwise and dose-response meta-analyses to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).

Main Results:

• A J-shaped relationship was observed between baseline platelet counts and outcomes, including all-cause death, MACE, and major bleeding.
• Low platelet counts (<175×10^9/L) were associated with a higher risk of bleeding events.
• High platelet counts (>250×10^9/L) were predominantly linked to an increased risk of ischemic events.

Conclusions:

• Baseline platelet count is a significant predictor of clinical outcomes after PCI.
• Thrombocytopenia (low platelet count) is primarily associated with bleeding risk.
• Thrombocytosis (high platelet count) is mainly associated with ischemic risk, impacting mortality and MACE.