Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Thrombocytopenia and acute coronary syndrome, what prognosis?
Session:
Posters 4 - Écran 2 - Doença Coronária
Speaker:
Maria Luísa Malvar Azevedo Magalhães Gonçalves
Congress:
CPC 2019
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Maria Luisa Gonçalves; Hugo Da Silva Antunes; Inês Pires; João Miguel Santos; Júlio Pereira; Davide Moreira; Inês Almeida; José Costa Cabral
Abstract
<p><strong>INTRODUCTION: </strong>Thrombocytopenia (Th) is a recognized marker of poor prognosis. Current management of ACS is associated with increased risk of bleeding from antithrombotic drugs (AD) and invasive procedures. There are no specific recommendations in the treatment of patients (P) with Th and ACS, most of which occurs in a case-by-case analysis.</p> <p><strong>OBJECTIVE:</strong> To evaluate the characteristics, treatment and hospital prognosis of P with ACS and Th.</p> <p><strong>METHODS:</strong> Selected P admitted by ACS between 2002-17, inserted in a national multicenter registry. P were divided into 2 groups, according with platelet (Pl) counts: Th group if <100,000/uL; or NTh. Comparative and multivariate analysis were done.</p> <p><strong>RESULTS:</strong> Out of a total of 13915 P, 1.4% had significant Th (n=191). Th group was characterized by older P (>75 years, 40.8 vs 30.4%, p=0.002) and a higher proportion of males (81.7 vs 72.6%, p=0.005), diabetics (40.4 vs 30.9%, p=0.005), previous MI (27.5 vs 19.2%, p=0.004), CABG (11.6 vs 4.6%, p=0.001), AF (12.1 vs 7.3%, p=0.011) and other comorbidities (valvular disease, peripheral vascular disease, neoplasia and COPD). At admission, Th group had lower systolic values (134±32vs 139±29mmHg, p=0.011) and hemoglobin (13.4±2.2 vs 13.8±1.9g/dL, p=0.016), and higher KK class (IV, 4.8 vs 1.7% p=0.005) and creatinine (1.3±1.3 vs 1.1±0.9mg/dL, p=0.001). Aspirin and ticagrelor were more frequently used in NTh (98.5 vs 94.7%, p=0.001; 18.4 vs 8.4%, p=0.001). Coronariography and angioplasty were less frequently performed in Th group (71.7 vs 87.1%, p=0.001; 59.3 vs 66.4%, p=0.038 r), with femoral access more frequently used (33.6 vs 20.8%, p=0.001) and no difference in vessel disease. If Pl<50,000/uL, enoxaparin was less frequently used (37.1 vs 59.5%, p=0.007). Th group related with development of CHF (28.8 vs 17.5%, p=0.001), cardiogenic shock (8.4 vs 3.8%, p=0.001), sustained VT (4.7 vs. 1.9%, p=0.012), need for blood transfusion (TF) (4.7 vs 1.9%, p=0.014) and hospital death (11.0 vs 3.3%, p=0.001). Th was found to be an independent risk factor for the need of blood TF (OR 3.22 [1.20-869] p=0.021; r 11x higher if Pl<50,000/uL). On discharge, a non-antiaggregation or anticoagulant strategy were more likely to belong to the ST group (17.0 vs 9.3%, p=0.001). Length of hospital stay was lower in the NTh group (6 [3-6] vs 7 [3-8] days, p=0.004).</p> <p><strong>CONCLUSION:</strong> Th was a marker of P at high cardiovascular risk and was associated with a greater number of hospital complications, however, it was only an independent predictor of TF. In the absence of recommendations, the clinical decision led to an underutilization of AD. It is important to check whether the poor prognosis is related to cardiovascular risk or underutilization of AD.</p>
Slides
Our mission: To reduce the burden of cardiovascular disease
Visit our site