糖蛋白Ⅱb/Ⅲa抑制剂相关性血小板减少症:临床预测指标及其对预后的影响

来源 :世界核心医学期刊文摘(心脏病学分册) | 被引量 : 0次 | 上传用户:lg97060329
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Glycoprotein Ⅱb/Ⅲa inhibitors are used as an adjunct to antiplatelet therapy in percutaneous coronary intervention to reduce postprocedural enzyme elevations. Previous studies have shown a risk for thrombocytopenia that is associated with these agents. We sought to evaluate the incidence and outcomes of glycoprotein Ⅲb/Ⅲa inhibitor-associated thrombocytopenia in an unselected series of patients undergoing percutaneous coronary intervention. We reviewed 984 interventions performed on 908 subjects over a specific time period. Glycoprotein Ⅲb/Ⅳa inhibitors were used in 58.8%of cases. Their use increased from 38 to 82%during the study period(p< 0.0001). The incidence of glycoprotein IIb/IIIa inhibitorassociated thrombocytopenia was 5.4%. The occurrence of thrombocytopenia was not associated with higher age, gender or ethnicity. The preprocedural platelet count was not associated with induced thrombocytopenia(237±76 vs. 209±68×103,p > 0.05). The occurrence of thrombocytopenia was not associated with increased in-hospitalmortality, 1-yearmortality,myocardial infarction or revascularization, but was associated with a hospital stay twice as long as in those patients without thrombocytopenia(5.6±11.3 vs. 2.1±2.2 days, p< 0.001). Of the 5.4%of patients who developed thrombocytopenia, only 2 patients(7.1%) required platelet or blood cell transfusion. Glycoprotein IIb / IIIa inhibitors are used as an adjunct to antiplatelet therapy in percutaneous coronary intervention to reduce postprocedural enzyme elevations. Previous studies have shown a risk for thrombocytopenia that is associated with these agents. We sought to evaluate the incidence and outcomes of glycoprotein IIIb / IIIa inhibitor-associated thrombocytopenia in an unselected series of patients undergoing percutaneous coronary intervention. We reviewed 984 interventions performed on 908 subjects over a specific time period. Glycoprotein IIIb / IVa inhibitors were used in 58.8% of cases. The incidence of glycoprotein IIb / IIIa inhibitorassociated thrombocytopenia was 5.4%. The occurrence of thrombocytopenia was not associated with higher age, gender or ethnicity. The preprocedural platelet count was not associated with induced thrombocytopenia (p <0.0001) 237 ± 76 vs. 209 ± 68 × 103, p> 0.05). The occurrence of thrombocytopenia was not associated with increased in-hospital transplant, 1-year transplant, myocardial infarction or revascularization, but was associated with a hospital stay twice as long as in as patients without thrombocytopenia (5.6 ± 11.3 vs. 2.1 ± 2.2 days, p <0.001). Of the 5.4% of patients who developed thrombocytopenia, only 2 patients (7.1%) required platelet or blood cell transfusion.
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