Background. Thrombocytopenia was intuitively considered to be associated with higher risk of bleeding and multiple comorbidities after percutaneous coronary intervention (PCI). However, controversial results exist, and the real-world clinical impact of thrombocytopenia in patients undergoing PCI is largely unknown. The aim of this study was to evaluate the influence of baseline thrombocytopenia on the prognosis of patients undergoing PCI. Methods. Using the West China Hospital Inpatient Sample database, patients who underwent PCI were identified from August 2012 to January 2019. Baseline thrombocytopenia was defined as a preprocedural platelet count of or less obtained from a routine blood sample taken within 48 hours before coronary PCI. The clinical effect of the advanced thrombocytopenia group (), according to the median value of platelet count in the thrombocytopenia cohort, was further assessed. The primary outcome was a composite of in-hospital death, bleeding events, and post-PCI transfusion. Results. Of 9531 patients enrolled in our study, 936 had baseline thrombocytopenia and 8595 patients did not have. There were no significant differences in the primary outcome between the two groups. However, advanced thrombocytopenia was independently associated with higher risk of primary outcome (OR 1.67, 95% CI 1.06 to 2.65, ). Acute coronary syndrome (ACS) patients with thrombocytopenia were associated with higher odds of major bleeding () (OR 2.56, 95% CI 1.24 to 5.44, ). Compared with the nonthrombocytopenia group, the thrombocytopenia group with ticagrelor use had higher odds of major bleeding (OR 9.7, 95% CI 1.57 to 60.4 versus OR 0.22, 95% CI 0.03 to 1.69, interaction ). Conclusions. It seems feasible for patients with thrombocytopenia to receive PCI, but close attention should be paid to advanced thrombocytopenia, the risk of postprocedure bleeding in ACS patients, and the use of more potent P2Y₁₂ inhibitor.

中文翻译：

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血小板减少症对接受经皮冠状动脉介入治疗的患者住院结局的影响

背景。直觉上认为血小板减少症与经皮冠状动脉介入治疗 (PCI) 后较高的出血风险和多种合并症有关。然而，存在有争议的结果，血小板减少症对接受 PCI 的患者的真实临床影响在很大程度上是未知的。本研究的目的是评估基线血小板减少对接受 PCI 患者预后的影响。方法。使用华西医院住院患者样本数据库，确定了 2012 年 8 月至 2019 年 1 月接受 PCI 的患者。基线血小板减少症定义为术前血小板计数从冠状动脉 PCI 前 48 小时内采集的常规血样中获得或更少。晚期血小板减少症组的临床疗效（)，根据血小板减少队列中血小板计数的中值，进一步评估。主要结局是院内死亡、出血事件和 PCI 后输血的综合结果。结果。在我们研究的 9531 名患者中，936 名患有基线血小板减少症，8595 名患者没有。两组的主要结局无显着差异。然而，晚期血小板减少症与较高的主要结局风险独立相关（OR 1.67，95% CI 1.06 至 2.65，）。伴有血小板减少症的急性冠状动脉综合征 (ACS) 患者发生大出血的几率较高。) (OR 2.56, 95% CI 1.24 至 5.44,）。与非血小板减少症组相比，使用替格瑞洛的血小板减少症组发生大出血的几率更高（OR 9.7，95% CI 1.57 至 60.4 对比 OR 0.22，95% CI 0.03 至 1.69，相互作用）。 结论。血小板减少患者接受 PCI 似乎可行，但应密切关注晚期血小板减少、ACS 患者术后出血的风险以及使用更有效的 P2Y ₁₂抑制剂。