Intra-aortic balloon pumping and thrombocytopenia in patients with acute coronary syndrome : Incidence, risk factors, and prognosis.
BACKGROUND:Thrombocytopenia is a frequently encountered phenomenon during intra-aortic balloon pumping (IABP), which may limit its prolonged utilization. The aim of the study was to explore the risk factors and clinical implications of IABP-associated thrombocytopenia in patients with acute coronary syndrome (ACS).METHODS:We retrospectively analyzed the data of 222 patients with ACS undergoing invasive treatment strategy supported by IABP. The incidence and risk factors of IABP-associated thrombocytopenia, and the association between thrombocytopenia and relevant clinical endpoints (in-hospital death, bleeding according to the TIMI scale, and thromboembolic events), were analyzed.RESULTS:IABP-associated thrombocytopenia was observed in 54.5% (121/222) of the patients. The incidence of thrombocytopenia was higher and the magnitude of reduction in platelet count was greater in the Arrow balloon group (n = 89) compared with the Datascope balloon group (n = 133; 68.5% vs. 45.1%, p = 0.001; 48.7% vs. 33.2%, p < 0.001; respectively). Independent predictors of thrombocytopenia included older age and Arrow balloon utilization (odds ratio [OR]: 1.054; 95% confidence interval [CI]: 1.028-1.080; p<0.001; OR: 2.468; 95%CI: 1.375-4.431; p = 0.002; respectively). The incidence of in-hospital death was higher in patients who developed thrombocytopenia than those who did not (9.1% vs. 2.0%, p = 0.041), and thrombocytopenia was correlated with in-hospital death (OR: 5.932; 95%CI: 1.221-28.822; p = 0.027). However, the rates of TIMI bleeding and thromboembolic events were similar between the two groups (5.8% vs. 5.0%, p = 1.000; 3.2% vs. 6.0%, p = 0.518; respectively), and thrombocytopenia was not associated with TIMI bleeding or thromboembolic events (OR: 0.940; 95%CI: 0.267-3.307; p = 0.923; OR: 0.541, 95%CI: 0.148-1.974, p = 0.352; respectively).CONCLUSION:IABP-associated thrombocytopenia occurred in 54.5% of patients with ACS undergoing an invasive strategy and it was correlated with increased in-hospital mortality. Older age and use of the Arrow balloon may predict IABP-associated thrombocytopenia.
