Clinical importance of thrombocytopenia occurring in the hospital phase after administration of thrombolytic therapy for acute myocardial infarction

摘要: Objectives. The purpose of this study was to examine the incidence and clinical implications thrombocytopenia that occurs in hospital after administration thrombolytic therapy for acute myocardial infarction. Background. use patients with infarction has improved mortality rates, but hemorrhage remains a major complication. Because may be associated therapy, we examined infarction. Methods. patient population comprised 1,001 enrolled Phases 2,3 5 Thrombolysis Angioplasty Myocardial Infarction (TAMI) trial urokinase trial. Patients received recombinant tissue-type plasminogen activator, or combination various dosing schemes. All heparin, aspirin calcium-channel blocking agent. Thrombocytopenia occurring anytime defined as nadir platelet count either <100,000/μl < 1/2 baseline. Blood loss quantified by bleeding index. Multiple logistic regression used evaluate independent contribution model predicting inhospital mortality. Results. occurred 16.4% patients, no difference among regimens. had lower median ejection fraction higher likelihood three-vessel coronary artery disease than without thrombocytopenia. more hemorrhage, in-hospital rate complicated course thrombocytopenia, even consideration other important variables, including age, fraction, number diseased vessels, bypass surgery intraaortic balloon counterpulsation. Conclusions. is common event excess mortality. Platelet counts should monitored daily because appearance identifies subset at increased risk death.